bluuebunny/crossref_metadata_2025 huggingface dataset:
Spiritual Influence Towards Relapse in Opioid Addicts in Therapy
Authors: MH Nurulhuda , M Najwa Haneem , CM Khairi , D Norwati , AA Aniza
Published: January 2021

Introduction: Substance abuse is both a social and public health problem with a substantial burden to society. Opioid dependence results in unemployment, crimes, family disruption, and transmission of diseases. In Malaysia, methadone maintenance therapy (MMT) has been introduced as a harm reduction method. However, relapse during treatment remains an issue to be resolved that hinders successful outcome in the therapy. Spirituality in the treatment of substance abuse disorders has yet to be fully explored. This study aims to examine how MMT clients who relapsed perceive spiritual deficits as an influence and association of spiritual practice with relapse. Methods: This is a cross-sectional study done from June-July 2016. All MMT clients undergoing therapy at 3 treatment centers in Terengganu, Malaysia who fulfilled the inclusion and exclusion criteria and consented were included in the study. A semi-structured questionnaire was filled via face to face interview and spiritual practice was assessed using Hatta Islamic Religiosity Scale. 121 questionnaires were assessed and data was analyzed using SPSS version 22 for quantitative data. Results: All respondents were males of Malay race and Islamic religion. Current relapse, defined as any episode of intake of opioid for the past one month after a period of abstinence was 34%. Only three out of 42 clients who relapsed had some spirituality theme in their perceived cause of their relapse. However, a significant majority of those relapsed had a spiritual practice score of less than the mean practice score. Conclusion: Relapse in opioid addiction remains high in those receiving MMT in Terengganu, Malaysia. Spirituality may have a subconscious influence towards relapse in addiction in MMT clients. Further effort should be taken to inculcate spirituality intervention effective to prevent relapse which may contribute towards achieving a more successful therapy outcomes.
Technical Issues in Craniomaxillofacial Distraction Osteogenesis: A Case Series
Authors: Chi Adam Khairul Bariah , Hariri Firdaus , Cheung Lim Kwong , Nabil Syed , Oo Aung Lwin , Abdul Rahman Zainal Ariff
Published: January 2021

Distraction osteogenesis allows superior skeletal advancement compared to conventional surgical osteotomy. It can be considered as a reliable and predictable surgical procedure and is widely used to correct the craniomaxillofacial bone discrepancy. Nevertheless, the outcome is technically dependent and requires comprehensive peri-operative assessment, preparation, and precision in application. The objective of this study is to highlight some important technical issues in distraction osteogenesis when the technique is indicated in various craniomaxillofacial regions and at the same time to discuss the options of preventing and overcoming these technical complications based on our experience and relevant literature. Important technical issues on the application of distraction osteogenesis in 5 different craniomaxillofacial regions were selectively highlighted based on the completed cases in one centre. Potential complications and its prevention methods were documented and discussed. The 5 highlighted regions of craniomaxillofacial distraction osteogenesis were alveolar, mandibular, cleft maxilla, craniofacial and facial cleft. Technical issues and complications were mostly device related and associated with anatomical limitations and surgical technique. Nevertheless, these complications are preventable and can be appropriately managed. From the literature and our experience, the technical aspects vary according to its application in different craniomaxillofacial regions. Preventing the potential complications contribute to the success of its application. This article also discussed the concept of Ihsan application in the medical field, to achieve the best of treatment in terms of delivery and technical preparation for the patients.
The Formulation of Classification for Islamization in Medicine: Review on 15 Years of Publications from Kulliyyah of Medicine
Authors: Arif Shahar Mohammad , Faiz Idris Mohd , Che Mohamad Che Anuar , Razali Zul Azlin
Published: January 2021

The Kulliyyah of Medicine of IIUM has pioneered the Islamization of Medicine in Malaysia since its establishment in year 1994. Therefore, it is timely to review publications on Islamization by the kulliyyah and also to propose a classification system in the field of researches to promote an organized, comprehensive, inclusive and relevant Islamization process. The aim is to review and classify publications on Islamization performed by the members of Kulliyyah of Medicine, International Islamic University Malaysia (IIUM). All researches and publications deposited in the IIUM Repository (IREP) under the Kulliyyah of Medicine between 1st of January 2000 and 31st of August 2016 were reviewed. Journal articles, posters and proceedings with Islamization themes were identified. These publications were classified based on common themes to either of the following; 1) "Islamic Principles and Related Rulings in Medicine"; 2) "Medical Treatment for Muslim Patients"; 3) "Islamic Input in Medical Practices"; 4) "Ruqyah and Tibb an-Nabawi in Contemporary Medicine". A total of 1616 items (journal articles, abstracts and proceedings) were reviewed. Sixty-one (3.8%) of them were related to Islamization. The major contributors to writings in Islamization are the Orthopaedics, Traumatology and Rehabilitation Department (10%) followed by the Internal Medicine Department (7.9%), from their total deposits in the IREP database. Majority (36.5%) of work were done in "Islamic Principles and Related Rulings in Medicine", which dwells in subjects such as euthanasia, autonomy and doctor-patient relationship followed by "Islamic Input in Medical Practice" (28.6%) which was related to topics in the medical curriculum such as Fiqh Ibadah for the sick. Twenty-three point eight percent (23.8%) of work were in the "Medical Treatment for Muslim Patients" which focuses on Ramadan and diabetes and joint problems and Solat. Minimal work (7.9%) was done in the "Ruqyah and Tibb an-Nabawi in Contemporary Medicine" category. Low number of publications on Islamization was deposited in the IREP database for the past 15 years. Based on the proposed classification system, majority of publications were on "Islamic Principles and Related Rulings in Medicine" and "Islamic Input in Medical Practice". More work is required on the theme of "Medical Treatment for Muslim Patients" and "Ruqyah and Tibb an-Nabawi in Contemporary Medicine".
Assessment of Sphenoid Sinus Variations and Its Related Neurovascular Structures Using Contrasted Thin Slice Computed Tomography Scan Of The Brain
Authors: Ahmed Nawal , Nafie Emad , Hassan Radhiana , Pasi Hafizah Binti
Published: January 2021

Introduction: Sphenoid sinus is the most variable structure in human. The prevalence of anatomical variations varies with the population. Increasing endoscopic procedures around the sphenoid sinus and advances in imaging techniques, allowed precise evaluation of sinus anatomical variation in each population. This study measured the prevalences and described the variations of the sphenoid sinus using thin slice contrasted computed tomography scan of brain scans. Materials and Methods: A retrospective cross-sectional study of 250 brain scans of patients between 18-60 years old attending Hospital Tengku Ampuan Afzan, Kuantan, Pahang from 1st January to 31st December 2017. The sphenoid sinus pneumatization types, volume, optic nerve relation according to Delano’s classification, internal carotid artery relation, and the number of sinus septum and attachment site were studied. Results: Post sellar pneumatization type was most common (52%). The mean sinus volume was 19 cm³ which was significantly different between genders. Delano optic nerve type 1 was most frequent (43%) and most were seen bilaterally with significant differences between gender. The internal carotid artery was seen non-protruded 41.6% cases, protruded in 36.4% cases, and protrusion with wall dehiscence in 22% cases. Two septate sinuses were more prominent (44.3%), aseptate sinus in 2.4% cases. The principle septa attachment site was sella (28%), internal carotid artery related septa found in 10% cases and 3.2% of cases with optic nerve septal attachment. Conclusion: This study revealed the presence of all sphenoid sinus variations amongst the study population. The preoperative determination of these anatomical variations minimizes vital neurovascular structures injury.
Cervical Spondylotic Radiculopathy: The Role of Conservative Management
Authors: Peng See Lei , Zakaria@Mohomad Zamzuri Bin , A/l Karupiah Rajandra Kumar , Perwira Marazuki bin Hj
Published: January 2021

Introduction: Cervical spondylotic radiculopathy is common and most patients experiencing an acute episode of unilateral radiculopathy without major motor deficit and no evidence of cord compression can be managed by non-operative measures. This study aimed to determine the severity of degenerative changes on plain radiograph among patients with cervical spondylotic radiculopathy and patient's self rated outcomes following conservative treatment. This study also looked into the correlation between pain with disability of patient, severity of degenerative changes of the cervical spine and different level of root compression. Materials and Methods: An observational cohort study where all patients with newly diagnosed cervical spondylotic radiculopathy were recruited from December 2016 to January 2018. Patient rated pain score and neck disability index at presentation and three months after conservative treatment were evaluated. Demographic data, radiographic severity grade, neck disability index and pain score were documented and analyzed via descriptive analysis and Pearson correlation test. Results: There were 29 patients recruited, with mean age of 49 years old. Forty one percent of patients had Grade 2 radiographic severity changes. Patient rated outcomes with neck disability index and pain score showed moderate improvement after conservative treatment (r=0.523, p<0.01). There was significant correlation between pain score and neck disability index (p<0.001). However, pain score showed no significant correlation between radiographic severity grade and different level nerve root compression. The power of this study is 0.8 with PASS 11 calculation. Conclusion: Patients with cervical spondylotic radiculopathy who were treated conservatively showed favorable clinical outcome.
Chronic Organic Arsenic Induced Liver Ultra Structural Damage
Authors: Saharudin Shahida , A. Talib Norlelawati , Abdullah Nor Zamzila , Ab. Rahman Jamalludin , Buyong Zunariah
Published: January 2021

Introduction: Inorganic arsenic is one of the environmental toxins that has been associated with increased risk of cardiovascular diseases and vascular contributions to liver diseases. It has generally been thought to be more toxic than organic arsenic. In human liver, inorganic arsenic promotes vascular remodelling, portal fibrosis and hypertension. The purpose of the current study was to determine whether chronic exposure to organic arsenic impair liver ultrastructure as in inorganic arsenic exposure. Materials and Methods: Twenty eight male SpragueDawley rats were divided into 2 groups with their own control group. They received oral intubation of monosodium- methylarsonate (MSMA) at 63.30 mg/kg body weight for 4 and 6 months duration respectively while the control groups received distilled water. The liver of euthanized rats were perfused- fixed with glutaraldehyde for transmission electron microscopy processing. Results: TEM revealed a marked reduction in the number of mitochondria in both treatment groups. Some typical features of apoptosis are present with pyknotic nuclei of hepatocytes and disintegrated hepatic cytoplasm in 4- month groups. The microvilli of hepatocyte are almost completely absent with the presence of many fibre bundles (collagen fibres) widening the space of Disse. In 6-month treatment group, disintegrated cytoplasms are more prominent with degrading mitochondria of varying stages. Liver sinusoidal endothelial cells (LSEC) of 6-month treatment group are noted to have chromatin condensation with few caveolae seen. Conclusion: Chronic exposure of MSMA leads to necrotic changes of hepatocytes and apoptotic changes in LSEC and collagenisation in the space of Disse.
Deformity Correction Surgery in Adolescent Idipathic Scoliosis-Our Early Experience
Authors: Japar Khan Ed Simor Khan Mor , A/L Karupiah Rajandra Kumar , Wafiuddin Ahmad Muhammad , Roslan Ahmad Faizal , Jasni Muhammad Jasfizal , Zakaria Zamzuri
Published: January 2021

Introduction: Adolescent Idiopathic Scoliosis (AIS) is the most common spinal deformity among teenage girls. It is defined as three dimensional lateral curvature in coronal plane of more than 10 degrees. For those indicated, early surgical intervention allows better surgical correction due to flexibility of the spine during teenage years, hence good functional outcome and better cosmesis can be expected. Materials and Methods: We reported our early experience in managing five patients surgically using the Posterior Spinal Instrumentation and fusion. Preoperatively patients were examined at IIUM Medical Centre spine clinic, all necessary investigations were carried out. Thorough explanation was done to patient and parents regarding procedure, risk and benefit. All patients were treated using same surgical technique. Neuromonitoring were used throughout the whole surgery until skin closure. All patients were hospitalised around one week. Post-operatively patients were follow-up at two weeks, six weeks, three months, and every six months thereafter. Result: It is important for clinicians to identify patients with AIS as early detection and timely treatment will change the natural history of curve progression. Conclusion: Surgical intervention when necessary will be easier and with less risk of complications when surgery was carried out during teenage years as the spine is more flexible and the deformity is less severe.
Establishment of Simultaneous Detection and Quantitation of HCVRNA by Third Generation Intercalating Dye Real-time PCR
Authors: Habil Akrahm M. Saleh , Hamzah Hairul Aini , Mustafa Muhammad Imad Al-Deen , A. Talib Norlelawati , Abdul Rahman Siti Nurul Fazlin
Published: January 2021

Introduction: Rapid quantification of hepatitis C virus is helpful in determining and monitoring of the disease progression and nature of the virus replication. The aim of the present study was to establish a fast, specific and sensitive tool for HCVRNA quantification. Materials and Methods: A total of 50 serum samples, comprising of 40 HCV-positive and 10 HCV-negative, were included in our study. RNA was extracted, reverse transcribed, and then subjected to real-time PCR amplification. Real-time PCR using EvaGreen dye and primers targeting a 5’UTR was carried out. Reference samples with known viral load were treated similarly to the unknown samples and used to create the standard curves. Results: Our method showed a high level of analytical specificity and accuracy, with a low limit of detection (~2 IU/ml). It yielded repeatable results with less than 4% of intra- assay variation. The assay covered a broad dynamic range of quantification, ranging from 0.34 to 6 log IU/ml. The diagnostic sensitivity, specificity, and accuracy were all 100%, indicating neither false positive nor false negative results were obtained. Conclusion: The developed real time PCR using EvaGreen dye has demonstrated a highly analytical and diagnostic performance for HCV quantification, suggesting its potential in clinical diagnosis and management.
Evaluation of High Resolution Melting Technique for Detection of JAK2-V617F Mutation in Formalin-Fixed Paraffin-Embedded Specimen from Myeloproliferative Neoplasm Cases
Authors: Abdul Saboor Mohammad Reza Abdullahi , Abdullah Nor Zamzila , Ismail Rosmawati , Muhammad Naznin , A. Talib Norlelawati
Published: January 2021

Introduction: Myeloproliferative neoplasm (MPN) is a group of myeloid disorder which lead to erythrocytosis, thrombocytosis and leukocytosis. MPN with BCR-ABL positive is chronic myeloid leukemia (CML) while BCR-ABL negative MPN includes polycythemia vera (PV), essential thrombocytemia (ET) and primary myelofibrosis (PMF). One of the major criteria for diagnosis of BCR-ABL negative MPN is the presence of JAK2-V617F mutation which is positive in 95% of PV and around 60% of ET and MF. Beside peripheral blood specimen, Formalin-Fixed Paraffin-Embedded (FFPE) marrow specimen can be used for detection of this mutation. Unfortunately, FFPE produces low quality DNA that put a challenge for successful amplification of DNA. We aimed to evaluate the utility of High Resolution Melting (HRM) analysis for detection of JAK2-V617F mutation in FFPE specimen from MPN cases. Materials and Methods: This study is a descriptive cross-sectional study. Forty FFPE marrow specimens were retrieved from the year 2014-2016. Bio-Rad Precision Melt Analysis software was used for analysis of HRM data. Allele-specific PCR was done for validation of results. Positive samples were subjected to Sanger sequencing. Results: JAK2-V617F mutation was positive in 3 out of 4 in PV, 0/2 in ET, 4/4 in PMF, 4/10 in non-classified MPN and 1/20 in CML. Level of agreement between HRM and AS-PCR was 97.5%. Conclusion: HRM is a rapid and powerful diagnostic assay, which is suitable for detection of JAK2-V617F mutation in FFPE marrow specimen.
Factors Regulating Nitric Oxide Production in Piper Sarmentosum Aqueous Extract Treated Spontaneous Hypertensive Rats
Authors: Mohd Zainudin Maizura , Elshami Taher F T , Ismawi Hidayatul Radziah , Fauzy Fatimatuzzhara Hashim
Published: January 2021

Introduction: High blood pressure is a major risk factor for cardiovascular diseases which is one of the leading causes of death worldwide. Piper sarmentosum (PS) leaves have been widely used in traditional medicine and it has been proven for its antihypertensive and antioxidant effects. This study aims to evaluate the antihypertensive potential of PS aqueous extract (PSAE) and to investigate the factors modulating nitric oxide (NO) production through its anti-oxidant activities. Materials and Methods: PS leaves were extracted with distilled water and freezedried. The PSAE was examined to quantify their antioxidant activities through DPPH and FRAP test. It is also screened for total phenolic and flavonoids content. The antihypertensive effect of PSAE in SHR was evaluated using four different groups (n=6); C group (negative control), K group (PSAE 500mg/kg), P group (3 mg/kg perindopril) and M group (PSAE + 1.5 mg/kg perindopril). PSAE and other treatment were given via oral gavage for 28 consecutive days. The blood pressure and heart rate were determined using the non-invasive blood pressure monitoring (NIBPM) tail cuff technique and recorded weekly for four weeks. SHR’s blood was collected for the determination of serum NO level using Griess assay. Asymmetric dimethylarginine (ADMA) and arginine levels were determined using HPLC. Results: PSAE shows good in-vitro antioxidant activities with significant reduction of BP and decreased serum ADMA level. Conclusion: PSAE enhances the clearance of ADMA that maintains arginine level, thus increasing the serum NO level, which ameliorate the blood pressure of SHR.
Knowledge and Practices on i-Ta'aleem and other Educational Technologies among International Islamic University Malaysia Kulliyyah of Medicine Lecturers
Authors: Mat Zin Nora Binti , Abd Aziz Karimah Hanim , AlHadeethi Yahia F Husin , Abd Ghani Muhammad Rasydan
Published: January 2021

Introduction: Technologies in the classroom require teacher’s knowledge and skills in utilizing it. Teaching for medical student can be different in some areas. To date, no studies has been conducted on the use of technologies among medical lecturer in International Islamic University Malaysia (IIUM). Thus, the objective of this survey is to determine the level of awareness, practice and perception of learning management system (i-Ta’aleem) and educational technologies among Kulliyyah of Medicine (KOM) lectures. Materials and Methods: This cross-sectional study was conducted among all IIUM KOM lecturers. Only 26.1% responded to the self-administered questionnaire which was distributed via google form for one month. Descriptive analysis was used to analyze the background information and their awareness, practice and perception. Results: Majority of the respondents were male (56.8%), permanent staff (94.6%) with mean years of service at IIUM was 6.7. Most of them owned technology tools [smartphone (100%), personal computer (73.0%), tablet (54.1%) and laptop (97.3%)]. All of them heard about i-Ta’aleem. However, 78.4% never use i-Ta’aleem and only a small percentage of them always uses other technologies for their teaching and learning (2.7% to 5.4%) except the usage of laptop (48.6%) and projector (59.5%). Conclusion: Although the lecturers were aware about i-Ta’aleem and owned high technology tools and gadget, only a small percentage of them use it in teaching activities.
Knowledge, Practice and Barriers of Pap Smear Screening among Patients in Obstetrics and Gynaecology Ward of the Largest Government Hospital in Pahang
Authors: Binti Azmi Nur Farha Adnin , Jefri Irrah , Faisal Nurul Nabilah , Mustaffa Kamarul Bahyah , Abd Aziz Karimah Hanim bt , Ong Nabilah
Published: January 2021

Introduction: Cervical cancer is the third most common cancer among women in Malaysia. It has the advantage of having the Pap smear as a reliable screening test. Unfortunately, the screening uptake in Malaysia is still very low. This study was performed to determine the knowledge, practice and barriers of Pap smear screening among sexually active patients in Obstetrics and Gynaecology wards in the largest government hospital in the state of Pahang. Materials and Methods: These cross sectional study was conducted in August 2017 using self-administered validated questionnaire covering the socio-demographic factors, knowledge on Pap smear and risk factors of cervical cancer, practice, and barrier of Pap smear screening. Bivariate analyses were used for associations between the variables. Results: The mean score of knowledge of the 156 women recruited was 52.01. Forty nine percents had good knowledge about Pap smear and only 39.7% ever had Pap smear screening. Majority of the patients were not aware of the risk factors for cervical cancer. The most common barrier to screening was time constraint (45.5%). There was statistically significant association between parity and practice of Pap smear (p <0.001) Conclusion: Knowledge and practice of Pap smear among the respondents were inadequate. These results indicated the need to increase effort in providing knowledge of Pap smear to the community. This is important for early abnormal cervical changes detection to further reduce the incidence of cervical cancer in Malaysia.
Neuroprotective Effect of Oral Administration of Trigonella Foenum-Graecum on Chronic Cerebral Hypoperfusion in Rat Model
Authors: Alruhaimi Hulol Saleh , Allow Ahmed Kaid , Bahbah Muhammed Naser , Buyong Zunariah , Rahman Shaikh Mizanur , Yousef Wael Mohamed
Published: January 2021

Introduction: Decreased cerebral blood supply to the brain can generate a condition of chronic cerebral hypoperfusion, which is one of the pathophysiological mechanisms of neuronal degeneration and cognitive impairment in Alzheimer’s disease. This study aimed to evaluate the potential neuroprotective effects of Trigonella foenum graecum seeds on chronic cerebral hypoperfusion in a rat model. Materials and Methods: Chronic cerebral hypoperfusion was induced by permanent bilateral ligation of the common carotid arteries (a two-vessel occlusion, 2VO) in male Sprague–Dawley rats. The experimental groups were divided into three groups (11 rats/group): i) sham (control) group; ii) 2VO group without any treatment; and iii) 2VO group that was administered orally with the Trigonella foenum graecum extract (100 mg/kg/day) by oral gavage from 3 days before the date of 2VO surgery and continued daily until the end of the 8th postoperative week. Spatial memory performance was assessed by the Morris water maze test. Malondialdehyde and C-reactive protein (CRP) concentration, superoxide dismutase and glutathione activities were measured in serum after 8 weeks from 2VO injury. Results: Chronic cerebral hypoperfusion rats resulted in spatial memory impairments. This behavioral dysfunction was accompanied by decreasing superoxide dismutase and glutathione activities, and increasing malondialdehyde and CRP levels in serum. Oral administration of Trigonella foenum graecum extract significantly improved the memory impairment, enhanced antioxidant enzyme activities, and decreased the malondialdehyde and CRP levels to near normal levels. Conclusion: The potential activity offered by Trigonella foenum graecum extract showed the neuroprotective effect that may be beneficial in cerebrovascular type dementia.
OrthoBoard: An Orthopaedic App for Medical Education
Authors: Liang Goh Kian , Noor Rahin Mohd Shahidan , Awang Mohd Shukrimi , Abdul Razak Ardilla Hanim
Published: January 2021

Introduction: Use of mobile apps as a pedagogical tool in the medical education has gained popularity as mobile apps have great potentials in perpetuating clinical knowledge and skills. To leverage mobile technology in medical education, we designed a hybrid mobile app based on our undergraduate orthopaedic curriculum. Materials and Methods: The frontend was created using hybrid mobile framework to target both iOS and Android platforms. The backend is powered by Firebase (Google Inc.) to manage authentication and social messaging. The content consisted of basic orthopaedic skills, trauma and resuscitation skills, Islamic input in orthopaedic and information cheatsheets. Results: OrthoBoard is being used by IIUM medical undergraduates as an ancillary source of learning, particularly useful as quick references and visual guides for enhancing orthopaedic knowledge and performing clinical procedures. The social messaging capability built into the app serves as a platform for discussion and exchange of information. This is the first medical app, to our knowledge, that integrates orthopaedic clinical knowledge and practice as well as Islamic input in orthopaedics into teaching and learning with the integration of social messaging as a platform for enhancement of knowledge and practice. Conclusion: Use of mobile apps as pedagogical tool in the medical education will undoubtedly increase in the future. As students and teachers embrace mobile technology in and outside the classroom, better user-centric and subject-specific apps will be required to fulfil the needs. For medical educators, developing mobile apps will possibly be one of the future armamentarium in the delivery of knowledge and skills.
Patients’ Knowledge and Perception on Anaesthesiologist And Anaesthesia
Authors: Nanyan Suhaila Binti , Johari Mohamad Fariz Bin , Holid Mohamad Nazrin Bin , Othman Usamah Bin
Published: January 2021

Introduction: Anaesthesiologists play vital roles in perioperative patients’ care and chronic pain management. However, not many patients are aware of the role of anaesthesiologists. We aimed to measure the level of patients’ knowledge regarding the role of anaesthesiologist and anaesthesia. Materials and Methods: This was a single-centred, questionnaire-based cross sectional study. The self administered questionnaire was divided into three parts that includes, i) sociodemographic characteristics, ii) knowledge regarding role of anaesthesiologist, iii) knowledge of anaesthesia. Respondents were selected among patients attending several specialist clinics at the International Islamic University Malaysia Medical Centre (IIUM MC). Results: Almost 64% of the selected patients had previous experience of anaesthesia. Majority of the patients (78%) knew that anaesthesiologist is a medical qualified doctor, but only 52.5% of them knew the role of anaesthesiologist in operation theatre. Fifty eight percents of patients realized the fact that anaesthesiologist is primarily responsible to ensures the well-being during operation, 45.1% knew the involvement of anaesthesiologist in case of emergency and in the intensive care unit, 46.7% in managing obstetrics pain, 39.3% in long-standing pain, 52.5% on the issue of pre-operative visits and post-operative recovery. Besides that, 72.1% were well-informed regarding fasting before operation, 59.8% realized that smoking may affect the anaesthesia and surgery, 86.1% knew where anaesthesia will be administered, 66.4% and 62.3% of respondents knew regarding the general and regional types of anaesthesia respectively. Seventy three percents of patients realize how general anaesthesia will be administered. Lastly, only 54.9% of patients had some knowledge regarding complications of anaesthesia. There were also not much impacts of previous exposure of anaesthesia on the level of their knowledge. Conclusion: Patients’ knowledge regarding the role of anaesthesiologist and anaesthesia were average and variable.
Proteomic Profiles of Young Adults with Acute Myocardial Infarction
Authors: Mohamed Bakrim Norbaiyah , Mohd Shah Azarisman Shah , Mohd. Shah Aida Nur Sharini , A. Talib Norlelawati , A. Rahman Jamalludin , Muhamad Bunnori Noraslinda , Idorus Mohd Yusri , Abdullah Aszrin
Published: January 2021

Introduction: The incidence of acute myocardial infarction (AMI) in young adults is increasing. However, a molecular study focusing on the pathophysiological changes in young AMI remains limited. This study aims to examine the proteomic profile of young adults with AMI compared to control subjects. We also hope to identify disease-specific protein biomarkers that contribute to the development of AMI in the young. Materials and Methods: Pooled plasma protein from 10 AMI patients aged 18 to 45 years and 10 age, gender and race-matched volunteers were separated using two dimensional electrophoresis (2-DE). The protein spots were analysed using the PD Quest analysis software. The protein spots that were found to have been expressed differently between the two groups were identified by Matrix Assisted Laser Desorption/Ionization Time of Flight (MALDI-TOF) Mass Spectrometry. Results: There were three differently expressed protein spots, namely Apolipoprotein AI (Apo AI), Apolipoprotein AIV (Apo AIV) and Haptoglobin. The expressions of these proteins were found to be increased in young patients with AMI compared to control subjects (p< 0.05). Conclusion:The up-regulation of Apo AI, Apo AIV and Haptoglobin in AMI patients could be in response to the inflammatory process associated with the recent cardiac event. The current study seems to reveal a significant function of these proteins during the acute phase response. Thus, Apo AI, Apo AIV and Haptoglobin are potential new biomarkers for young AMI.
Psychosocial Distress and Blood Pressure among Young Adults: Role of Cortisol as Mediator
Authors: Wan Omar Wan Fatein , Musa Ramli , A. Rahman Jamalludin , Mohd Shah Azarisman Shah , A. Talib Norlelawati , Aung Sithu , Abdullah Aszrin
Published: January 2021

Introduction: Hypertension is the most prevalent risk factor of cardiovascular diseases in Malaysia. 17.3% of hypertension cases in Malaysia is attributed to adults aged 18 to 39 years. Psychosocial distress is a possible risk factor for elevated blood pressure in young adults, and cortisol could be the mediating factor. The aim of this study is to evaluate the mediating role of cortisol in hypertension and psychosocial distress in young adults. Materials and Methods: A comparative crosssectional study was conducted in 240 young adults aged 45 years or less. The body mass index, waist circumference and blood pressure parameters were recorded. Serum cortisol, creatinine, fasting blood glucose and lipid profile were measured following acute mental stress test. Psychosocial distress was assessed using the DASS-21 questionnaire. Results: Mean (standard deviation) values for SBP, DBP and MAP were 126.0 (16.3), 84.1 (12.2) and 98.1 (13.1) mmHg respectively. Anxiety was significantly associated with systolic blood pressure (β = 0.644), diastolic blood pressure (β = 0.454) and mean arterial pressure (β = 0.516) after adjusting to sex, age and cortisol. However, it was not mediated by cortisol. Depression and stress were not found to have any effect on blood pressure of the young adults studied. Conclusion: The data suggest that there is no elevated risk for psychosocial distress and hypertension that cortisol poses in young adults.
Pulmonary Artery Aneurysm: A Very Rare Entity
Authors: Mustapha Wan Irfan Wan , Md Ralib Ahmad Razali , Kamarudin Norie Azilah
Published: January 2021

Pulmonary artery aneurysm (PAA) is defined as a focal dilatation of the pulmonary artery. It is noted to be a very rare entity. From literature reviews, only 8 cases of pulmonary artery aneurysms being identified from a total of 109,571 cases within an extended period of 100 years. This gives an incidence of about 0.0073%. It is usually associated with some structural cardiac anomalies, structural vascular anomalies, pulmonary hypertension, vasculitis and infection. However idiopathic pulmonary artery aneurysm has also been identified in some cases. It can be classified as proximal or peripheral PAA depending on its location. Most of the patients are asymptomatic. The symptoms are only seen when complications occurred, such as bronchial or tracheal compression, dissection, rupture, thrombus formation causing pulmonary hypertension. It can be treated conservatively or surgically, especially in a symptomatic patient or if the size is more than 6 cm. We reported a case of left pulmonary artery aneurysm, which is an incidental finding in a patient who underwent a CT pulmonary artery in view of a suspected pulmonary artery embolism when he presented with sudden onset of shortness of breath and left lower limb swelling and pain for one week. A left pulmonary artery aneurysm is seen measuring about 4.2cm (W) x 3.9cm (CC) extending to the proximal branch of descending pulmonary artery. Unfortunately, no further treatment can be given to the patient in view of the patient succumbed from sepsis shortly after the diagnosis.
Qualitative Study on Perception of Antenatal Mothers towards Oral Health Care: In-depth interview
Authors: Ab. Halim Noorhazayti , Esa Rashidah , Syah Md Muziman
Published: January 2021

Introduction: Attending regular dental check-up is very important to pregnant women. However, many women do not utilize oral healthcare services during the antenatal period. It had been reported in Health Information Management System report (MOH, 2007) that the attendance of antenatal mothers to dental clinic were unsatisfactory. Therefore, the aim of this research was to explore the perception of antenatal mothers towards oral health care. Materials and Methods: In-depth interviews were carried out with a convenience sampling of 20 antenatal mothers across three government health clinics in Selangor, Malaysia. The interview using guided questions which explored participant’s oral health knowledge, attitude and oral health practice. All interviews were audio recorded, transcribed verbatim and analysed by thematic analysis. The interviews were carried out until the saturation of information were achieved. Results: The main themes emerging from the data related to low oral health knowledge, poor attitude and oral health practices during pregnancy. Although all participants have basic knowledge of dental caries development, however, many of them unaware of the significance of preventive dental visits during pregnancy. Poor attitudes and oral health practices among antenatal mothers in this study were due to they had not received the necessary oral health information. Conclusion: Antenatal mother’s perception of oral health care crucially impacts on oral health status, continuity of utilization of oral healthcare services and hence pregnancy outcome. Their views provided a baseline information for planning and formulating appropriate oral health education and promotion strategies.
Recurent Ectopic Pregnancy Score As Predictor To Fertility Outcome Following Tubal Ectopic Pregnancy
Authors: Mohd Nor Nurul Yaqin
Published: January 2021

Introduction: Ectopic pregnancy may occur in fallopian tube, ovary or abdominal cavity. This study focused on tubal pregnancy outcome. The return of fertility after operative removal of tubal ectopic pregnancy was examined in 237 women who were admitted to Hospital Sultanah Nur Zahirah (HSNZ) for ectopic pregnancy between 2012 and 2016. The follow-up period averaged six months to four years. Materials and Methods: This was a case control, retrospective non-comparative study. Data collected from HSNZ Human Resources Management Information System (HRMIS). Patient who has no pregnancy or delivery record after six months of ectopic event were contacted via phone. Multivariate analysis was done to identify score for patients who were at risk of recurrence, and who require fertility help. Results: One hundred forty eight women (64%) aged 20-35 years old able to conceive spontaneously after ectopic pregnancy, with the mean-time of 8 months if one tube is patent. Ninety three percents of those who conceived had intrauterine pregnancy, 5% had recurrent ectopic pregnancy. Conclusion: From a multivariate analysis, a scoring system, Recurrent Ectopic Pregnancy (REP) score was made to choose most suitable patient for laparoscopic intervention, preserve fertility or facilitate fertility. Significant REP score of 4/5 suggest laparoscopic salpingectomy with contralateral sterilization to prevent recurrence of ectopic. Patient with REP score 2-3 may have spontaneous conception and REP score less than 1/5 will require further fertility treatment.
Sacral Tuberculosis: An Atypical Manifestation
Authors: Si Mirah Faisal Amir , Roslan Ahmad Faizal , Japar Khan Ed Simor Khan Mor , Karupiah Rajandra Kumar , Mohamad Zamzuri Zakaria @
Published: January 2021

Sacral tuberculosis (TB) is extremely rare and its unusual entity might delay the diagnosis and treatment of this treatable disease. A 38-year-old lady presented with a 1 year history of lower back pain with radiculopathy more to right lower limb. The patient was initially treated as Prolapsed Intervertebral Disc (PID), but showed no improvement despite regular physiotherapy and medication. Subsequently, the pain was confined to the right gluteal area and became more severe. Quality of life was impaired in which patient started using walking aids and stopped working. There was a weight loss of 20kg. No other symptom of TB infection or history of contact with TB patient. Bowel and urinary functions were normal. Examination showed localized tenderness at the right gluteal area. Neurological assessment of both lower limbs were MRC grade 5. Blood investigations were normal including the ESR level (17mm/hour). Mantoux test was positive with 18mm induration. MRI revealed a large rim enhancing paravertebral collection at pre-sacral space which extended into bilateral piriformis and gluteal muscles. The patient underwent CT-guided drainage of both gluteals and specimens taken to confirm the diagnosis of TB. Patient showed significant improvement clinically within 1 week after the drainage procedure and initiation of antituberculous chemotherapy. The initial presentation of this patient mimics PID due to irritation of sciatic nerve at piriformis level. However a change in the presentation and failure of conservative treatment should raise a high index of suspicion and necessitates further investigation to establish correct diagnosis hence proper treatment can be initiated.
Solitary Infratentorial Tuberculoma Mimicking Tumour in a Paediatric Patient: A case report
Authors: Abu Bakar Intan Bazilah , Zahari Zaharul Azran , Hassan Radhiana
Published: January 2021

Central nervous system (CNS) tuberculosis is a rare form of extrapulmonary tuberculosis, which account for about 5% of cases. It is the most hazardous type of systemic Tuberculosis (TB) due to its high mortality rate and possible of causing serious neurological complication. In the CNS Tuberculosis, meningitis and tuberculoma are the common radiological findings, whilst rarely an abscess. Tuberculoma is a granulomatous inflammatory process that may imitate a neoplasm, both clinically and radiologically. We herein report the case of a 2-year old girl who presented with unusual clinical and imaging studies of tuberculoma, mimicking an intracranial tumour. This case highlights the challenges in making the diagnosis, until a proper treatment is made.
The Effects of Aquilaria Malaccensis Leaves Aqueous Extract on The Sperm of Sprague Dawley Rats Towards Early Embryogenesis
Authors: Ismail Faridah , Abdul Wahab Azantee Yazmie , Md Isa Muhammad Lokman , Abdul Razak Redzuan Nul Hakim , Raja Ismail Raja Arif Shah
Published: January 2021

Introduction: Oxidative stress induced by excessive and unopposed levels of reactive oxygen species in male reproductive system results in impaired sperm quality, fertilization capacity and poor embryo development. Our goal is to assess the potential effects of Aquilaria malaccensis (AM) leaves, a plant with strong antioxidant property on early embryo development in vitro and embryo quality following fertilization with cyclophosphamide (CP) exposed rat sperm. Materials and Methods: Forty eight male Sprague Dawley rats were allocated into eight groups of six rats (n = 6): control, CP only (200 mg/kg), AM only (100 mg/kg, 300 mg/kg and 500 mg/kg) and CP + AM (100 mg/kg, 300 mg/kg and 500 mg/kg). Animals were sacrificed after 63 days of treatment and sperm from caudal epididymis were taken for in vitro fertilization (IVF) with oocytes from untreated female. Fertilization, embryo division and embryo morphology were examined after 24 hours post fertilization and compared between groups. Statistical evaluations were performed using Chi-Square test and Fisher’s exact test and pvalue < 0.05 was considered significant. Results: Co-administration of AM leaves extract at dose 100 mg/kg/day to CP-treated group has significantly increased (p < 0.05) the fertilization rate, early cleavage rate and embryo quality compared to CP only treated group. Conclusion: Overall, the present results indicate the potential of AM leaves extract supplementation to improve the fertility and early embryo development in male rat exposed to CP by inhibiting the oxidative processes and scavenging free radicals.
The Effects of Paternal Perinatal Depressive and Anxiety Symptoms on Newborn Low Birth Weight
Authors: Md. Rifin Sakinah
Published: January 2021

Introduction: Despite significant improvement in health status in Malaysia, the prevalence of low birth weight (LBW) in newborns remained unchanged over the past 12 years. In the past decade, there have been assumptions regarding the potential etiologic association of psychosocial factors with LBW. It is widely believed that only mothers are affected by depression and anxiety during pregnancy. However, this study aimed to investigate the independent effects of paternal antepartum depressive and anxiety symptoms on LBW newborns in Kuantan, Pahang. Materials and Methods: A prospective cohort study of 450 expectant fathers was carried out in six conveniently selected government health clinics in Kuantan, Pahang. Paternal antepartum depressive symptoms were assessed using Edinburgh Postpartum Depression Scale (EPDS) and anxiety symptoms using Depression Anxiety Stress Scale-21 (DASS-21) and they were followed-up until delivery. Newborn birth weight of singleton live babies delivered at term (≥37 weeks) were recorded to the nearest 0.1kg from Infant and Child Health Record. Descriptive analysis along with chi-square and independent sample t-test were carried out together with multiple logistic regression model to identify predictors of LBW. Results: After adjusting for potential cofounders, paternal depressive (OR=4.29; 95% CI 1.17-15.72) and paternal anxiety (OR= 4.62; 95% CI 1.74-12.26) symptoms were significantly associated with LBW (≤2.5kg). Conclusion: This study showed that paternal depressive and anxiety symptoms increased the risk of newborn LBW. Therefore, it is crucial to detect and manage the depressive and anxiety symptoms for expectant fathers during antenatal care to reduce the burden of LBW.
Improving Health Care Delivery through Islamization of Medical practice
Authors: Rathor Mohammad Yousuf , Shah Azarisman SM
Published: January 2021

Advances in modern science and technology have not only reduced mortality from communicable diseases but increased physical comfort, life expectancy and quality of life. However its advances have generated changes in the moral values and basic philosophies of mankind, a bi-product being loss of faith in religion as a partner in healing. This has resulted in changes in lifestyle, moral degradation, laxity in sexual behaviours, and disrupting social values. New diseases caused by negative lifestyles such as sexual promiscuity, alcoholism, illicit drug use and smoking, take the greatest toll in terms of deaths and disability among young people. As a consequence, relevant international organizations have supported more novel approaches to health promotion.Good health is the basic requirement of every human being and one of the greatest blessings of ALLAH (SWT) on mankind. The Islamic way of life is a system of divine principles sent by Allah swt through revelation on Prophet Muhammad (saw) which covers physical, intellectual and spiritual needs of human life. It has many constructive ideas to offer in the field of health care and medical practice. It contains many teachings that urge nurturing of one’s health and rejecting any behaviour, which are contradictory to health. Therefore by adopting an “Islamic way of life” we can promote behavioural change. Since Islam encourages adoption of modern technology and science in support of a greater good, we must understand it and adopt all that is good in it and propagate it in the spirit of Tawhid (Unity of God), for the benefit of all humanity. This paper seeks to analyse how medical professionals can promote healthy behaviour to specific target groups and public in general through teachings of Islam.
Islamic Perspective on Importance of Breastfeeding: Two Case Reports
Authors: Mokhtar Nurhawa , Sulaiman Fatin Syuhadah , Kusumawardani Anisa , Hidayat Taufiq
Published: January 2021

Breast milk contains all basic nutrition needed by a child. Exclusive breastfeeding is recommended to all infants in their first 6 months of life. Infants who had been exclusively breastfed have a better health status compared to infants who were introduced with mixed feeding in their early life. Exclusive breastfeeding not only gives benefits to the child, but also to the mother. In infants it offers protective mechanism in lowering risk of gastrointestinal infection and promotes bonding between the mother and the child. The first case was a 2 years and 7 months old girl who was admitted to Hospital Tengku Ampuan Afzan Kuantan due to acute gastroenteritis with some dehydration. She had been admitted a month earlier due to pneumonia. She was breast fed exclusively for 3 months after she was born. Formula feeding was started after she turned 4 months old.. The second case was a 1 year and 4 months old boy who was hospitalized due to acute bronchiolitis. He was not breast fed due to no milk production. Islam views childhood as a critical phase in molding an individual. Parents have been entrusted by Allah to observe and fulfill the rights of the children in providing a conducive environment for them to develop and grow. A good healthcare and proper nutrition are among the child’s rights that need to be filled by the parents. Islam emphasizes the importance of breastfeeding up to 2 years old as a way in providing good nutrition. Islam also provides solution for mothers who are unable to breastfed their child by adopting wet mother. Parents are responsible in providing good health and nutrition for their children. Breastfeeding is also highly encouraged by Islam because it provides medical benefits for both mother and children.