Authors: Ismail Burud, Davaraj Balasingh, Hikmatullah Qureshi, Davendralingam Sinniah.

ABSTRACT

Urethral catheterisation is a common and safe procedure performed routinely. The small size of the urethra in a child necessitates the use of an infant feeding tube (Size 5 to 8 F) for catheterisation. Knotting within the bladder is a rare complication with significant morbidity often necessitating surgical or endoscopic removal. Insertion of an excessive length of tube contributes to coiling and knotting. We report an instance of knotting of an infant feeding tube in the proximal penile urethra of a 4 year-old male child requiring urethrotomy to remove it. Awareness of the risk and proper technique can reduce this complication.

Keywords: Urethral catheter, knotting, infant feeding tube.

Citation: IeJSME 2013 7(1): 37-39

DOI: https://doi.org/10.56026/imu.7.1.37

Authors: Niekla S Andiesta, Zeinab Abbas Hasan, Chooi Gait Toh.

ABSTRACT

Pain and anxiety management is of paramount importance in dentistry especially for child patients. The term “Medicated Oxygen” or “Magic Air” refers to a mixture of nitrous oxide and oxygen gases that is commonly used for partial sedation in pediatric dental populations. The gas is colorless and virtually odorless with a faint, sweet smell. Nitrous oxide sedation is administered by inhalation, absorbed by diffusion through the lungs, and eliminated via respiration. In children, sedation may accelerate the delivery of dental treatment that requires patient serenity and may allow the patient to tolerate unpleasant procedures by reducing anxiety, discomfort, or pain.

Keywords: “Medicated Oxygen”, nitrous oxide, a 9-year old anxious boy.

Citation: IeJSME 2013 7(2): 47-50

DOI: https://doi.org/10.56026/imu.7.2.47

Authors: Nazimah Idris, Sivalingam Nalliah.

ABSTRACT

This paper attempts to utilise clinical scenarios where ethical issues are embedded and requires appropriate application of the steps of the framework mentioned. A step by step sequential approach is adopted to illustrate how the ‘ethical decision model’ can be used to resolve ethical problems to arrive at a reasonable conclusion. The UNESCO ethical method of reasoning is used as the framework for decision making. Physician educators should be competent to use ethical decision models as well as best available scientific evidence to be able to arrive at the best decision for patient care as well as teach health professional trainees how reasonable treatment decisions can be made within the perimeter of medical law and social justice.

Keywords: bioethics, clinical practice, decision-making model, medical education, obstetrics and gynaecology.

Citation: IeJSME 2014 8(1): 44-49

DOI: https://doi.org/10.56026/imu.8.1.44

Authors: Hui Min Chong, Shien Yee Ng.

ABSTRACT

The case report describes the presentation of a 19-year old female with tuberous sclerosis who presented with progressive dyspnoea over 2 days. Chest radiograph revealed bilateral pneumothorax. Computed tomography showed features of pulmonary lymphangioleiomyomatosis and bilateral renal angiomyolipomas. The coexistence of both conditions may cause devastating morbidity and mortality.

Keywords: Tuberous sclerosis, lymphangioleiomyomatosis, pneumothorax.

Citation: IeJSME 2014 8(2): 30-34

DOI: https://doi.org/10.56026/imu.8.2.30

Authors: Zuraida Zainun, Sy Nadiah Sy Saifuddin.

ABSTRACT

Chronic vestibular problem or disorder is a complicated vestibular disorder that can involve multiple complications such as psychological and others. A standard and latest term that is globally used for this chronic disorder is recurrent vestibulopathy. Recurrent vestibulopathy is defined as an illness of unknown cause characterized by more than a single episode of vertigo of duration characteristic of that occurring with hydrops, but without auditory or clinical neurological symptoms or signs for more than 6 months’ duration. During this pandemic period, home-based module is one of the valuable rehabilitation methods to treat non benign paroxysmal positional vertigo vestibular cases. Vestibular Rehabilitation (VRT) is a specific form of physical therapy designed to habituate symptoms and promote adaptation to and substitution for various aspects of deficits related to a wide variety of balance disorders. Most VRT exercises involve head movement which are essential in stimulating and retraining the vestibular system. Bal Ex is a home-based module of VRT with specific modules that are available in three forms viz. manual book, poster and DVD. This module was developed with a combination of customized Cawthorned Cookseey Exercise and prayer movements. Foam exercise is one of the VRTs. It consists of twenty movements divided into three levels. This physical exercise module has many advantages. In this case study we evaluated the effectiveness and psychological improvement in chronic vestibular problem using level 1 Home-based Balance Rehabilitation in a 30-year-old female patient.

Keywords: Bal Ex, home-based module, Recurrent Vestibulopathy, Bal Ex Module, imbalance.

Citation: IeJSME 2021 15 (2): 35-37

DOI: https://doi.org/10.56026/imu.15.2.35

Author: Davendralingam Sinniah

ABSTRACT

Nebulization with B-agonist and administration of systemic corticosteroids are standard treatments for severe asthma exacerbations, but corticosteroids take several hours to become effective. IV magnesium sulphate (MgSO4) acts faster and has both antiinflammatory and bronchodilating properties. It appears to have played a pivotal role in the successful management of a child with severe asthma exacerbation and atelectasis unresponsive to conventional therapy. A literature review reveals that the results of IV MgSO4 are much greater in children than in adults, and can avoid the need to hospitalize 25% of children presenting with severe asthma. Magnesium sulphate appears safe to use.

Keywords: intravenous magnesium sulphate, asthma exacerbation, pulmonary atelectasis.

Citation: IeJSME 2014 8(3): 45-48

DOI: https://doi.org/10.56026/imu.8.3.45

Authors: Surenthiran Ramanathan, Chin Voon Tong.

ABSTRACT

Papillary thyroid microcarcinoma is not uncommon and constitutes almost one third of all differentiated thyroid carcinomas. It is generally regarded as low risk and usually an incidental finding from histopathology examination. Some areas of management of this entity remains uncertain and requires a multidisciplinary approach. We present a patient who initially came to us with symptoms of hyperthyroidism, later underwent thyroidectomy for a suspicious lesion but was found to have micropapillary thyroid carcinoma in another part of her thyroid gland.

Keywords: Papillary thyroid microcarcinoma, hyperthyroidism.

Citation: IeJSME 2017 11(3): 30-31

DOI: https://doi.org/10.56026/imu.11.3.30

Authors: Kamarul Izham Kamarudin, Nur Dini Mohd Yusof, Suresh Chopra.

ABSTRACT

Open reduction and internal fixation using conventional lateral distal femur locking plate is a standard operative method for distal femur fracture. This case series describes medial plating of distal femur fracture using proximal tibia locking plate that is anatomically fit to the medial aspect of distal femur, by the minimally invasive plate osteosynthesis (MIPO) technique which gives a stable construct with good outcome.

Keywords: Distal femur, medial plating, proximal tibia locking plate.

Citation: IeJSME 2017 11(3): 32-34

DOI: https://doi.org/10.56026/imu.11.3.32

Authors: Win Lin Chai, Yuen Hoong Phang, Hwee Cheng Chong.

ABSTRACT

Tumoral calcinosis is an uncommon condition which has been described to exist in primary and secondary forms. A lack of awareness of this entity can lead to unnecessary procedures and incorrect management. We report a case of a patient on peritoneal dialysis who presented with multiple painful joint swellings to the orthopaedic department. An initial diagnosis of septic arthritis was made, then revised to chronic tophaceous gout and referred to the rheumatology unit.

Keywords: Dialysis, gout, orthopaedics, rheumatology, tumoral calcinosis, joint.

Citation: IeJSME 2018 12(1): 18-20

DOI: https://doi.org/10.56026/imu.12.1.18

Authors: Ren Yi Kow, Hazwan Ab Wahid, Ruben Jaya Kumar, Ed Simor Khan Mor Japar Khan, Colin Komahen, Chooi Leng Low.

ABSTRACT

Cervical spine injury is commonly associated with road-traffic accidents. The true incidence of cervical spine injuries is unknown due to under-reporting of such injuries. Cervical spine injury is associated with high morbidity and mortality if it is missed. With the advancement of imaging modalities, the number of missed cervical injuries has reduced. Nevertheless, some clinicians are dependent solely on imaging tools to rule out cervical spine injury in a trauma victim. We report two cases of “near miss” C6 fracture to highlight the importance of a detailed clinical history and clinical examination with imaging as an adjunct to rule out cervical injury.

Keywords: cervical fracture; trauma; spine; radiology; computed tomography; magnetic resonance imaging.

Citation: IeJSME 2018 12(1): 21-26

DOI: https://doi.org/10.56026/imu.12.1.21