Prevalence and awareness of lower urinary tract symptoms among males in the Outpatient Clinics of Universiti Kebangsaan Malaysia Medical Centre.

This study aims to determine the prevalence of lower urinary tract symptoms (LUTS) and level of awareness among male outpatients in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). A questionnaire consisting of demographic data, questions related to knowledge, attitude and practice on BPH and the International Prostate Symptom Score (IPSS) was used for this study. Uroflowmetry and bladder scan were used to evaluate the function of the urinary tract and severity of BPH. Urine dipstick was done for glycosuria, proteinuria and haematuria. A total of 220 respondents were surveyed. The prevalence of moderately and severely symptomatic LUTS was 42.7%. The most commonly reported LUTS were nocturia (78.2%), frequency (58.2%) and incomplete emptying (44.6%). The prevalence of glycosuria, proteinuria and haematuria were 23.6%, 11.4% and 1.8% respectively. There was a significant association between increasing age with the severity of LUTS (p=0.005). Out of 102 respondents with voided urine volume greater than 150 mL, there was a significant decrease in maximum (Qmax) (p=0.039) and average (Qave) urine flow rates with every 10 years increase of age (p=0.001). The majority of respondents (59.5%) have heard of BPH before. Over 78.2% of the respondents would seek medical attention if they have LUTS with 15.9% saying they would seek traditional treatment. In conclusion, the prevalence of LUTS was high and the level of awareness was satisfactory

Lesión vesical iatrogénica: experiencia de diez años, tratamiento y resultados entre 1999-2009, Kuala Lumpur, Malasia

Introduction: This case series is a retrospective review of iatrogenic bladder injuries treated at our institution Universiti Kebangsaan Malaysia, Medical Centre, over a ten-year period, from 1999 to 2009. Materials and methods: A retrospective review of the operating theater database yielded the names and registration numbers of patients who underwent operative repair of bladder injuries. Patients who sustained bladder injuries due to nonsurgical reasons (such as traumatic bladder injuries due to pelvic fractures, blunt trauma or penetrating injuries to the pelvis) were excluded. Results: There were 12 cases of iatrogenic bladder injury treated during this time. A total of eight injuries occurred during gynaecological surgery. Five injuries occurred during lower segment caesarean section, two injuries during total abdominal hysterectomy and bilateral salpingo-oopherectomy, and a single injury during Burch colposuspension. Four out of the five injuries during caesarian section had a history of previous caesarian section. Of the four remaining non-gynaecological related injuries, two injuries occurred during hernioplasty, one during exploration of an enterocutaneous fistula and the other was during laparoscopic appendicectomy. Conclusion: Iatrogenic bladder injury should be anticipated in patients undergoing caesarean section who have had multiple previous caesarean sections. Iatrogenic injuries should be identified intra-operatively to enable early repair and the best outcome. These injuries were adequately assessed by ascending cystography. Continuous repair with absorbable sutures together with perivesicle drainage and bladder catheterization produces good outcome. Introducción: Esta serie del casos es una revisión retrospectiva de heridas iatrogénicas de vejiga tratadas en la Universidad Nacional de Malasia entre 1999 y 2009. Métodos: Se hizo una revisión retrospectiva de la base de datos de la sala de cirugía del Centro Médico de la Universidad Nacional de Malasia, en individuos a quienes se les realizó cirugía de heridas de vejiga. Se excluyeron los pacientes que presentaron heridas de vejiga sin cirugía como heridas traumáticas debido a fracturas pélvicas, trauma cerrado o heridas penetrantes en la pelvis. Resultados: Se encontraron 12 casos de herida de vejiga iatrogénica tratados entre 1999 y 2009. Ocho heridas ocurrieron durante cirugía ginecológica, 5 durante cesárea segmentaria baja, 2 durante histerectomía abdominal total y salpingo-ooforectomía bilateral y 1 herida durante colposuspensión de Burch. Las 4 heridas restantes no ginecológicas fueron: 2 heridas por iatrogenia ocurrida durante una hernioplastia, una durante exploración de una fístula entero-cutánea y la otra se presentó durante una apendectomía laparoscópica. Conclusión: La herida iatrogénica de la vejiga debe ser anticipada en pacientes que experimentan cesárea que han tenido múltiples cesáreas previas. Las heridas iatrogénicas deben ser identificadas intra-operatoriamente para permitir reparación temprana y obtener el mejor resultado. Obtuvo mejores resultados la reparación continua con suturas absorbibles junto con drenaje vesical mediante catéter. La cistografía ascendente con 300 ml de contraste es la mejor opción para el diagnóstico de herida iatrogénica de vejiga y también para la evaluación de la reparación total

Kencing Manis dan Diet: Beberapa Fakta Penting untuk Direnungi Bersama

Kencing manis (DM) adalah penyakit metabolik yang bercirikan hiperglisemia, di mana adanya gangguan dalam pengeluaran atau tindakan insulin atau gabungan kedua-duanya. Biasanya, terdapat beberapa faktor seperti faktor genetik, obesiti, gaya hidup tidak sihat, aterosklerosis dan juga tabiat pemakanan yang salah yang menyebabkan atau memburukkan DM. Biasanya, individu yang terlibat tidak mengambil berat tentang kesihatannya dan kesan daripada komplikasi DM ini boleh mendatangkan maut. Komplikasi DM melibatkan sistem kardiovaskular, otot, endokrin, buah pinggang dan sistem saraf di dalam badan. Rawatan komplikasi DM bukan sahaja mahal tetapi ia juga menjadi beban kepada keluarga yang terjejas. Kajian ini membincangkan cabaran yang dihadapi dalam menangani DM dengan mengambilkira diet dan tabiat pemakanan. Pengetahuan daripada pengambilan makanan yang betul juga boleh membantu memerangi komplikasi DM dan ini dapat menangani kadar kematian dan morbidit

Combining radiographic, urodynamic and ultrasonographic techniques for the evaluation of urinary bladder structure and function in an animal model

The urinary bladder can be affected by either congenital or acquired disease leading to small, noncompliant, hypertonic urinary bladder with subsequent transfer of high pressure to upper tract leading to renal function deterioration and renal failure. The aim of urinary bladder reconstruction was to restore normal structure and functions of the urinary bladder. Successful reconstructions should be confirmed by measurement and evaluation of bladder structure and functions. In this study, different modalities such as radiography (CT scan), ultrasonography, and urodynamic were used to assess urinary bladder structure and functions in an animal model. The radiographic (CT scan) and ultrasonography have mostly structural data, while urodynamic studies produce functional parameters. Using these combined modalities we could measure and determine the normal urinary bladder volume, bladder filling pressure, voiding pressure, bladder shape, outline border, three dimension (3D) configurations, locations, and bladder dimensions. Radiography showed bladder as oval, contrast filled hollow organ, localized centrally. Mean bladder volume was 1.42 ml±0.03. Ultrasonography showed bladder as oval, elongated hypo echoic urine filled organ with, wall thickness 1mm at bladder dome and 2mm at bladder base. Mean volume was 1.44 ml±0.05. Urodynamic study showed low intravesical filling pressure with a mean value of 6-5 cm H2O, while the mean voiding pressure was 18-19cmH2O. Mean bladder volume was 1.40 ml±0.02. The acquired data for the normal (control) animals may be used as a reference for further evaluations of our future research on urinary bladder reconstructions using tissue engineering technology

Postnatal urinary incontinence: prevalence and factors associated with it in a Malaysian population.

The aim of this study was to investigate the prevalence of postnatal urinary incontinence (PNUI), the risk factors associated with it and postnatal women’s (PN) level of engagement in practicing traditional Malay confinement care (TMCC) in Kelantan, Malaysia. A cross-sectional survey was conducted among 362 postnatal women aged between 18 – 45 years and who were between three to five months post-delivery. Participants were selected through convenience sampling at six Maternal and Child Health Clinics located in comparatively similar districts. Descriptive and inferential analyses including, factor analysis, Pearson chi-square, Mann-Whitney U test and logistic regressions analysis were used for data analysis. Overall, PNUI was reported by 80 women (22.1%). Vaginal delivery was associated with PNUI. All PN women within the study context practiced TMCC. The findings revealed that women who had PNUI were more likely to engage in a higher level of the ‘Body care’ component of TMCC. UI is prevalent among PN women in Kelantan, Malaysia. Further research into the impact of the ‘body care’ component of TMCC on PNUI is required

Asian Men’s Health: Gender Disparity and Life Expectancy.

The aim of this review was to analyze the gender disparities found as well as the life expectancies in Asia. An analysis of the data on gender disparities as well as life expectancies of the different Asian countries was done based on the World Health Organization (WHO) Global Health Observatory Data Repository as well as the regional government databases. Middle Eastern countries have the highest male to female population ratio. The results show that in terms of population pyramid, Asia is moving towards a more geriatric population. Qatar has the highest life expectancy for men and is the only country in Asia where men live longer than women (difference of 2 years). In general, women in Asia live longer than men. High income countries like Hong Kong, Japan and Singapore have higher life expectancies as compared to those on the lower income nations. The life expectancy of Asian men still lags women. Men’s health care needs to be addressed urgently. The disparity in income-status reflecting the lifespan of men is an impetus for us to narrow the gap of health in Asian countries

The Impact of a Patient Education Package on Outcomes of Pain Management Following Orthopaedic Surgery in a Tertiary Hospital in Malaysia

Kepercayaan pesakit terhadap pengurusan kesakitan boleh menjejaskan hasil pengurusan kesakitan dan kualiti hidup. Tujuan kajian ini dijalankan adalah untuk menentukan kesan pakej pendidikan pra-operasi sakit ke arah kepercayaan kesakitan dalam kalangan pesakit-pesakit yang menjalani pembedahan ortopedik di hospital tertiari. Reka bentuk kajian ‘pre-test pos-test’ satu-kumpulan dijalankan pada pesakit-pesakit untuk menentukan impak pakej pendidikan tentang kesakitan terhadap skor ‘post-test’ kepercayaan tentang kesakitan dalam kalangan pesakit yang menjalani pembedahan ortopedik. Tiga puluh responden telah diambil menggunakan ‘convenience sampling’. Pendidikan tentang kesakitan sebelum pembedahan berkaitan dengan pengurusan kesakitan diberikan kepada respons.Skor kepercayaan pra-operasi dan pos-operasi sakit, pengurusan markah dan kesan-kesan sampingan telah diukur dengan menggunakan borang soal-selidik halangan (BQ-13). Keputusan melaporkan perbezaan yang signifikan antara skor ‘pre-test’ (Mean = 41.87, Standard Deviation = 11.467) dan ‘post-test’ (Mean = 34,80, Standard Deviation = 13.026) kepercayaan terhadap kesakitan (t = 2.84, p =0.004). Terdapat juga perbezaan yang signifikan antara skor ‘pre-test’ (Mean = 37.10, Standard Deviation = 10.610) dan skor ‘post-test’ (Mean = 30.80, Standard Deviation = 11.424), pengurusan kesakitan (t = 3.856, p =0.0005). Responden dan jantina (t =-2.403, p =0.023) dan bangsa (F = 5.038, p =0.014) melaporkan perbezaan yang signifikan iaitu p 0.05. Kesimpulannya, terdapat kesan positif daripada pakej pendidikan kesihatan berkenaan kepercayaan kesakitan dan pengurusan kesakitan responden yang telah menjalani pembedahan ortopedik di hospital tertiari. Pengukuhan program pendidikan kesakitan adalah penting untuk mencapai matlamat pengurusan kesakitan pos-operasi yang optimum

The Impact of Dry Needling on Patients with Neck Pain in a Tertiary Hospital

Neck pain presents as a symptom of dull pain or discomfort mainly along the trapezius muscle. Dry needling is an invasive procedure which uses acupuncture needle directed at myofascial trigger points. The aim of the study was to evaluate the effectiveness of dry needling in managing patients with neck pain. A pre-test-post-test interventional study design was used. Patient education package was provided to 32 respondents who fulfilled the inclusion criteria. A 13-item Pain Catastrophizing Scale (PCS) questionnaire was used to assess Rumination, Magnification and Helplessness. Subjective pain intensity was measured by Visual Analogue Scale (VAS). These questionnaires were given before and after the dry needling intervention. The findings reported that respondents scored high in pre-test total PCS score (27.41±13.652). Post-test result revealed a significant improvement in total PCS score (23.06±13.938) (p = 0.000). Post-test VAS score (4.78±1.237) was also significantly better than pre-test (6.47±1.414) (p = 0.000). There was no significant difference in pre-test PCS in terms of marital status (p > 0.05) whereas there was significant difference between marital status and rumination in post-test (Z = -2.303, p = 0.021). There was significant difference between pre-test magnification in terms of respondents’ occupation (p = 0.008) and race (p = 0.035) but no significant difference in post-test. Respondents’ age group showed no significant differences between pre-test and post-test PCS and VAS (p > 0.05). In conclusion, patients who received dry needling showed improvement in pain intensity and catastrophizing towards neck pain