Cement Vertebroplasty In The Elderly With Osteoporotic Vertebral Fractures. A Preliminary Study On The Change In Activity Of Daily Living After Treatment

Posted Posted in Original Article

Author: Collin Looi Seng-Kim

ABSTRACT

Background: To assess the effect of cement vertebroplasty on the activity of daily living of elderly patients who have sustained a vertebral osteoporotic fracture.

Patients and Methods: Seven patients with clinically significant and radiologically proven osteoporotic vertebral compression fractures suitable to be treated with percutaneous cement vertebroplasty were recruited. Evaluation was based on pre- and postprocedure activity by clinical documentation (including interview) and by a self-developed questionnaire (including quality of life).

Results: Following the procedure, 54% of patients resumed their activities of daily living with minimal pain while 46% of patients were able to do so without any pain (p<0.05). Up to 85% of patients did not require any form of medication (p<0.05) and 77% of patients were found to have no pain. In addition to that, almost 62% of patients were able to ambulate normally.

Conclusion: Percutaneous cement vertebroplasty appears to significantly improve the activities of daily living of elderly patients who have sustained vertebral osteoporotic fractures. It is also found to be a safe procedure which contributes to reduced usage of medication, immediate pain reduction and improvement in functional status of the patient.

Keywords: Percutaneous cement vertebroplasty, quality of life, daily activity.

Citation: IeJSME 2009: 3 (2): 8-13

DOI: https://doi.org/10.56026/imu.3.2.8

Prevalence Of Exclusive Breast Feeding And Its Correlates In An Urban Slum In Western India

Posted Posted in Original Article

Authors: Patil Sapna S, Hasamnis Ameya A, Pathare Rooma S, Parmar Aarti, Rashid A K, Narayan K A.

ABSTRACT

Background: The World Health Organization recommends the practice of exclusive breastfeeding of infants for the first 6 months after birth. The objective of present study was to estimate the prevalence and the factors influencing exclusive breastfeeding. The perceptions of mothers about breastfeeding in an urban slum area of Western India were also enquired.

Methods: This cross sectional study was conducted over six months amongst 200 mothers of children in the age group of 6 – 12 months attending the growth and development clinic in one of the urban health centres. Data was collected using a pre-tested, structured questionnaire on breastfeeding practices. Factors related to exclusive breastfeeding were analysed using bivariate and multivariate analysis.

Results: Prevalence of exclusive breastfeeding reported by the participants was 61.5%. Having a male child, maternal age < 30 years, level of education of mother, parity, receiving infant feeding advice, initiation of breastfeeding within one hour of birth and administration of colostrum to the baby were associated with exclusive breastfeeding (p<0.001). Multivariate logistic regression analysis revealed that male sex (adjusted odd ratios: 20.03), primiparity (0.19), home delivery (0.32), receiving infant feeding advice (5.90), initiation of breastfeeding within one hour of birth (0.26) and giving colostrum to the baby (2.56) were independently associated with exclusive breastfeeding. Prelacteal feeds were given by almost 35% of mothers.

Conclusion: Prevalence of exclusive breastfeeding was higher than the national figures. However, practices like discarding the colostrum, giving prelacteal feeds, early/late weaning and use of formula feeds are still widely prevalent and need to be addressed.

Keywords: Breastfeeding, Exclusive breastfeeding, Prelacteal feeds, India, Urban.

Citation: IeJSME 2009: 3 (2): 14-18

DOI: https://doi.org/10.56026/imu.3.2.14

Traditional Male Circumcision In A Rural Community In Kedah, Malaysia

Posted Posted in Original Article

Authors: Rashid A K, Teh Swee-Ping, Narayan K A.

ABSTRACT

Background: Circumcision though not mentioned in the Quran is believed to be a compulsory practice among the Muslims. In Malaysia, although there are several methods of circumcision available and traditional circumcision is still popular.

Methods: A cross-sectional survey was carried out in a small fishing village of Kedah to study the methods of circumcision available to the villagers. This was followed with an in-depth interview conducted with ‘Tok Mudim’, a practitioner of traditional method of circumcision.

Results: Forty three of the eligible 71 subjects participated in the study giving the response rate as 60.5%. The most common age for circumcision was 9 years old. Despite private clinics being the most common place of circumcisions, there was an increasing number of boys going to the ‘Tok Mudim’ for circumcision. A Mass Circumcision Ceremony is traditionally practiced. The ‘Tok Mudim’ described the procedure in detail and was of the opinion that the reason traditional method is still popular was because of the fear of injections and impotency among the parents. Most common complication faced by the ‘Tok Mudim’ was bleeding and infection.

Discussion and Conclusion: Till the community shifts entirely to using modern medicine, there is a need to integrate traditional practitioners into the system. Training the ‘Tok Mudim’ to use modern instruments and aseptic techniques should be considered.

Keywords: Male circumcision, rural, Malaysia.

Citation: IeJSME 2009: 3 (2): 19-23

DOI: https://doi.org/10.56026/imu.3.2.19

Gingival Fibromatosis with Chronic Periodontitis – A Rare Case Report

Posted Posted in Case Study & Report

Authors: Sanadi Rizwan M

ABSTRACT

Gingival fibromatosis is frequently an isolated condition of little consequence apart from a cosmetic problem and occasional associations with uncommon syndromes. This case report of a 38 year old female patient describes the gingival enlargement associated with chronic periodontitis. The enlargement extended beyond the middle thirds of the clinical crowns of the teeth. It was associated with generalized mobility, pocket formation and bone loss. The patient also complained of bleeding gums and difficulty in speech and mastication. This is the first case report of gingival fibromatosis associated with chronic periodontitis.

Keywords: Bleeding gums, chronic periodontitis, gingival enlargement, gingival fibromatosis, mobility, pocket formation.

Citation: IeJSME 2009: 3 (2): 24-27

DOI: https://doi.org/10.56026/imu.3.2.24

Role of Ampicillin-Sulbactam: A District Hospital’s Experience in Treating Diabetic Foot Ulcers

Posted Posted in Research Note

Authors: Ng C S, Vadivelu M, Chan K Y.

ABSTRACT

Ampicillin-sulbactam combination is the most frequently prescribed antibiotic in diabetic foot ulcers. We conducted a retrospective study to evaluate the antibiotic sensitivity of bacteria isolated to this antibiotic. In 33 patients with diabetic foot ulcer (September 2008-March 2009), 67% were culture positive in which Citrobacter spp accounted for 36% of these isolates. The rest isolated included Pseudomonas aeruginosa (22%), Proteus spp (18%), Acinetobacter spp (9%), Klebsiella pneumoniae (5%), Escherichia coli (5%) and Staphylococcus aureus (5%). These isolates were more likely to be ampicillin-resistant (n=18) than were ampicillin-sensitive isolates (n=4). Ampicillin resistance has raised our concern about current practice of prescribing ampicillin/ sulbactam as monotherapy for majority of our patients with such ulcers.

Keywords: Diabetic foot ulcers, Ampicillin-sulbactam, District hospital.

Citation: IeJSME 2009: 3 (2): 28-30

DOI: https://doi.org/10.56026/imu.3.2.28

Medical Informatics For Medical Students And Medical Practitioners

Posted Posted in Review Articles

Author: Jai MOHAN

ABSTRACT

The importance of incorporating medical (or health) informatics into the education of medical students and medical practitioners is being increasingly recognised. The advances in information and communication technology and the pervasion of the Internet into everyday life have important implications for healthcare services and medical education. Students and practitioners should learn to utilise biomedical information for problem solving and decision making based on evidence. The extensive introduction of electronic health information systems into hospitals and clinics and at the enterprise level in Malaysia and elsewhere is driving a demand for health professionals who have at least basic skills in and appreciation of the use of these technologies. The essential clinical informatics skills have been identified and should be incorporated into the undergraduate medical curriculum. It is recommended that these be introduced in stages and integrated into existing programmes rather than taught as a separate module. At the same time, medical schools should support the integration of e-learning in the educational process in view of the numerous potential benefits.

Keywords: Medical informatics, medical students, information & communication technology.

Citation: IeJSME 2010: 4 (1): 2-6

DOI: https://doi.org/10.56026/imu.4.1.2

An Investigation Into The Learning Styles, English Proficiency And Assessment Performance Of Medical Students

Posted Posted in Original Article

Authors: Toh Peng YEOW, Mark Kiak Min TAN, Li-Cher LOH, Julia BLITZ.

ABSTRACT

Appreciation of learning styles can be of use to help both educators and students to enhance the effectiveness of an educational experience. It has been noticed that some students at this College are not very good at expressing themselves in either written or spoken English. Our study aimed to identify the student’s learning styles; assess whether there is any correlation between learning style, baseline demographic data and self rated proficiency in English language; and assess their associations with the assessment performance.

A group of third year medical students voluntarily participated in a questionnaire study to provide us with their learning styles, demographic information and self-rated proficiency in English language. This data was compared to the students’ performance in the assessment at the end of their junior clinical rotations.

This cohort of students (60% Malay, 35% Chinese and 5% Indian) who were mostly visual learners, considered themselves proficient in English. Students with predominantly Visual learning styles and those with poorer English, score significantly lower during their clinical long case examinations. These two predictors appear to be independent of each other.

These results may suggest that our current teaching modalities may disadvantage students with predominant visual learning styles. It also suggests that the long case clinical examination may favour those with more verbal learning styles.

Keywords: Clinical performance, English proficiency, Learning styles, Visual learners.

Citation: IeJSME 2010: 4 (1): 7-13

DOI: https://doi.org/10.56026/imu.4.1.7

Bacillus Thuringiensis Parasporal Proteins And Their Effect On Human Cancer Cells : An Overview

Posted Posted in Review Articles

Author: Shin Yee Rebecca Wong

ABSTRACT

Bacillus thuringiensis is an anaerobic, spore forming bacterium that produces various toxic proteins both during its vegetative stage and sporulative stage. During its sporulative stage, it produces parasporal proteins that have long been used in the agriculture fields as insecticides. Although anticancer effect of Bacillus thuringiensis parasporal proteins can be dated back to the 1970s, research in this area went through a giant leap in the late 1990s, with much of the work being done in Japan. It has been found that some strains of non-insecticidal Bacillus thuringiensis produce parasporal proteins that exhibit anticancer activity. Due to their selectivity against human cancer cells but not normal cells, some of these proteins have been extensively studied for their anticancer effect and the mechanism of action by which these proteins kill cancer cells have also been widely explored in Japan and Malaysia with sporadic reports from other parts of the world. The abundance of these bacilli in nature and their selectivity have made them potential candidates for cancer treatment. However, literature on the in vivo effect of these proteins is scarce. Since different Bacillus thuringiensis strains produce different cytotoxic proteins with wide variations in their anticancer effect and mechanism of action, further investigations are necessary and their effect in vivo must be well established before they can be used in human subjects.

Keywords: Bacillus thuringiensis, Non-insecticidal, Non-haemolytic, Parasporal proteins, parasporin, Anticancer activity.

Citation: IeJSME 2010: 4(2): 3-9

DOI: https://doi.org/10.56026/imu.4.2.3