Author: Pei Kuan Lai

A palatal swelling transpires out as a nasal B-cell Non-Hodgkin’s Lymphoma

Posted Pei Kuan LaiPosted in Case Study & Report

Authors: Sunil Pazhayanur Venkateswaran, Rafiq Abdul Karim Vasiwala, Norfadzilah Mohd Yusof.

ABSTRACT

Primary sinonasal Non-Hodgkin’s Lymphoma’s (NHLs) are quite rare and emulate the presentation of benign inflammatory diseases. It is challenging to distinguish them morphologically and radiologically from other malignant neoplasms. We report a 37-year-old male patient who presented with obstruction of the nasal passages, rhinorrhoea, epistaxis, post nasal drip, facial swelling, orbital symptoms and pyrexia. The mass was a nasal diffuse large B-cell lymphoma confirmed by immunohistochemistry. After the first cycle of chemotherapy was started, the patient improved with resolution of the facial swelling, pain and visual defects. A high index of suspicion is required to differentiate sinonasal lymphomas from other lesions.

Keywords: Diffuse large B-cell lymphoma, palate, CD20, CD79α, and KI-67.

Citation: IeJSME 2018 12(2): 22-25

DOI: https://doi.org/10.56026/imu.12.2.22

Femoral deformity correction and lengthening on nail with monorail external fixator : A case report

Posted Pei Kuan LaiPosted in Case Study & Report

Authors: Mohd Bakrynizam Abu Bakar Siddiq, Kamarul Izham Kamarudin, Kamarul Al Haq, Suresh Chopr.

ABSTRACT

Limb length discrepancy (LLD) is quite common. Lower limb shortening is one of the causes of limb length discrepancy. The common treatment that is used is the llizarov technique for bone lengthening. The new technique uses an intramedullary nail with a monoplanar external fixator. Using this technique, bone lengthening duration in patients can be reduced and knee joint mobility can be improved without jeopardizing bone regeneration. We report a case of a 27-year-old gentleman who had right femur shortening from childhood and was referred to us for corrective deformity. He underwent bone lengthening on the nail which lenghthens and equalizes the leg while avoiding stiffness and reduces joint mobility which leads to good patient satisfaction outcome. The use of the external fixator with intramedullary nailing to lengthen the femur is one method that can reduce patient burden mentally and physically. However although it has many advantages we must watch out for the complications during the regular visits to ensure good outcome.

Keywords: Bone lengthening, limb length discrepancy, external fixator.

Citation: IeJSME 2018 12(2): 26-29

DOI: https://doi.org/10.56026/imu.12.2.26

Surgical management of a mangled foot by a free vascularized fibular graft: A case report

Posted Pei Kuan LaiPosted in Case Study & Report

Authors: Ren Yi Kow, Akmal Azim Ahmad Alwi, Aziah Abdul Aziz, Muhammad Firdaus Abas, Chooi Leng Low.

ABSTRACT

The human foot serves as an important part to support the body weight and accounts for the majority of our movements. A mangled limb involves injury to at least three out of four systems, namely the soft tissues, nerves, blood supply and bone. While amputation is indicated in some cases of mangled limb, with proper planning, limb salvaging surgical management is also a viable option. Special consideration to the skeletal stabilization, control
of infection, vascular status and soft tissue coverage is paramount to the success of limb salvaging surgery. We present a case of mangled limb which was successfully treated with limb salvaging surgical management. Initial debridement, Kirschner wires insertion and cross ankle external fixation were used for skeletal stabilization. An antibiotic spacer was inserted for local antibiotic and to maintain the length left due to the loss of medial and intermediate cuneiform bones. The anterior tibialis artery and its venae comitantes were utilized for free vascularized fibular graft to provide bony reconstruction as well as soft tissue coverage for the mangled foot.

Citation: IeJSME 2018 12(2): 30-33

DOI: https://doi.org/10.56026/imu.12.2.30

Bone transport using semicircular Ilizarov ring fixator in the treatment of the infected nonunion of the humerus: A case report

Posted Pei Kuan LaiPosted in Case Study & Report

Authors: Kamarul Izham bin Kamarudin, Jun Wei Then, Ching Wooi Yeoh, Ying Jing Ooi, Chopra S.

ABSTRACT

Bone transport using the Ilizarov technique has been one of the most popular techniques in treating fracture with significant bone defect. However, pain and joint stiffness following Ilizarov fixation are few of the well-known complications. We report a case of a 23-year-old gentleman with a closed left humeral diaphyseal fracture following a traffic accident who underwent plating of the left humerus which was later complicated with infected nonunion. He was then treated with corticotomy and bone lengthening using the semicircular Ilizarov ring fixator. Good clinical and functional outcomes were observed during transportation period (elbow flexion 10̊ to 90̊) with minimal complications.

Keywords: Semi-circular Ilizarov rings, infected nonunion, bone transport.

Citation: IeJSME 2018 12(2): 34-36

DOI: https://doi.org/10.56026/imu.12.2.34

Factors associated with depression among adults in Mantin, Malaysia

Posted Pei Kuan LaiPosted in Original Article

Authors: Sarvesh Seger, Chen Giap Tee, Samin Uddin, Wen Han Sia, Mie Aye Lwin.

ABSTRACT

Introduction: Depression is a debilitating illness and has become a leading cause of disability worldwide. According to the National Health Survey IV, the prevalence of lifetime depression was 2.4% and current depression was 1.8%. In a review article published by the Department of Psychological Medicine, University of Malaya, the prevalence of depression in Malaysia was estimated to be between 8% and 12%. A cross-sectional study carried out in Selangor, Malaysia showed that 10.3% of adults aged 18 and above suffered from depression. Depression carries dire societal and health-related consequences that affect both the individual and the community as a whole, and is potentially a chronic illness with high morbidity, rate of relapse and recurrence. This study was performed to identify the prevalence of depression and factors associated with it.

Method: A cross-sectional study was done on 354 Malaysian adults above the age of 18 residing in the district of Mantin, Malaysia. Non-Malaysians and people with known-depression were excluded. A questionnaire was developed to detect the sociodemographic factors and Patient Health Questionnaire 9 (PHQ-9) was used
to screen for depression.

Results: The proportion of the participants shown to score mild to major depression was 44.4%. Higher prevalence was found in individuals who were males (45.2%), in the age group of 38 years and below (48.3%), Malays (45.5%), having low levels of income (46.0%), having lower levels of education (45.7%), not married (48.1%), a parent (45.3%), having positive family history of depression (60%) and suffering from chronic illnesses (48.4%). Satisfaction with family members was a strong and independent factor associated with depression (OR 3.051, CI 1.445-6.444, p-value 0.002).

Conclusion: The prevalence of depression in the study population of Mantin was high and significantly associated with family satisfaction. Creating awareness regarding depression in this community is recommended. Projects and programmes encouraging individuals to connect with the family should be considered. In addition, policies should be put in place to promote more family time in the community.

Keywords: Depression, prevalence, associated factors, PHQ-9, Malaysia.

Citation: IeJSME 2019 13(1): 4-14

DOI: https://doi.org/10.56026/imu.13.1.4

The inter-observer variations in symphysio-fundal height measurements obtained by fourth year medical students: Are they associated with maternal and observer factors?

Posted Pei Kuan LaiPosted in Original Article

Authors: Gerald Jian Ming Lee, Sze Mi Tey, Tze Keei Lim, Kar Siang Chew, Rajitha Chamath Wickrama, Malik Goonewardene.

ABSTRACT

Introduction: Inter-observer variations are one of the several limitations in the use of Symphysis-Fundal Height
(SFH) measurements which are frequently used to screen for foetal growth abnormalities prior to ultrasound foetal biometry.

Objectives: The objectives of this study are to measure the interobserver variations of SFH measurements obtained
by Semester 8 medical students of the International Medical University (IMU), Malaysia and to determine whether there is any association between maternal and observer factors and the inter-observer variations.

Method: A cross sectional study was carried out among 77 pairs of the IMU Semester 8 medical students who underwent training in the Obstetrics and Gynaecology (O&G) posting from 26th February to 31st May 2018. The first student in each pair was aware of the patient’s demographics, her gestational age (GA) and her obstetric complications if any, while the second student was blind to all the maternal data. The Limits of Agreement between the two SFH measurements obtained by a pair of students were calculated. The association between the inter observer variations in the SFH measurements obtained by a pair of students and maternal height, weight, GA, parity, body mass index (BMI) and the students’ duration of training in the O&G posting were studied.

Results: The limits of agreement between the two SFH measurements obtained by a pair of students were very wide and ranged from – 6.0 cm to + 5.6 cm. Approximately 34% of the 77 pairs of students had inter-observer variations of SFH within the clinically acceptable limit of – 2cm to +2cm. There was no association between inter-observer variations in SFH and maternal height, weight, GA, parity, body mass index (BMI) and the students’ duration of training in the O&G posting.

Conclusions: There were wide inter-observer variations between the SFH measurements obtained by IMU Semester 8 medical students but the variations were not associated with maternal or observer factors.

Keywords: Inter-observer variations, symphysio-fundal height measurements, medical students, maternal factors, observer factors.

Citation: IeJSME 2019 13(1): 15-25

DOI: https://doi.org/10.56026/imu.13.1.15

A bibliometric study of the publication type and citation count of Medical Journal of Malaysia for the period 1980-2016

Posted Pei Kuan LaiPosted in Original Article

Authors: Cheong Lieng Teng, Kean Ghee Lim, Ee Ming Khoo, Chirk Jenn Ng, Lee Yen Chong, Mei Yee Lee, Nawal Aqilah Amir, Jia Ling Voon, Wilson Wei Sheng Chin.

ABSTRACT

Objectives: To evaluate study designs and citation counts of original research published in the Medical Journal of Malaysia (MJM).

Methods: The bibliographic data of the MJM for the period 1980-2016 were retrieved from PubMed and analysed using Endnote bibliographic software. Study designs of original journal articles were analysed according to whether the articles were diagnostic study, prognostic study or clinical trial (collectively known as “evidence papers”). The citation counts of the original articles and case reports for the period 2012-2016 were compared in a sub-study using a case-control design.

Results: A total of 3952 MJM journal items were retrieved from PubMed for the period 1980-2016; of these, 58.9% were original articles and 29.5% were case reports. Among the original articles, 14.6% were “evidence papers”; 2.3% were diagnostic studies, 7.7% were prognostic studies, 4.6% were clinical trials. In the study period 2012-2016, “other types of original articles” had statistically significantly more citations than case reports. However, there is no difference between “evidence papers” and case reports.

Conclusion: Our analysis shows the distribution of the types of articles appearing in the MJM for the period of study and serves as a reference for improving citations counts in the local context.

Keywords: Bibliometrics; Citation count; Medical Journal of Malaysia; Study design.

Citation: IeJSME 2019 13(1): 26-32

DOI: https://doi.org/10.56026/imu.13.1.26