Advanced abdominal pregnancy with dead foetus: a case report

Abdominal pregnancy is a rare form of ectopic pregnancy in which the zygote implanted within the peritoneal cavity exception at ovaries, fallopian tubes and intra ligament spaces. The diagnosis is challenging and can be missed especially when the imaging facilities are not available in remote areas.A 35 years old, G3P2+0 was admitted to the hospital at 38+2 weeks of pregnancy with the chief complaint of reduced foetal movement for three days. She was taking regular antenatal care with the midwife at the rural health centre and uneventful until 37 weeks of pregnancy. On physical examination, the abdomen was distended, the foetal parts were easily palpable, no visible foetal movement and the foetal heart sound was not audible. Abdominal ultrasound scan identified the term foetus of abdominal pregnancy without foetal cardiac activity. The patient underwent laparotomy and dead, male foetus was extracted uneventfully. The placenta was attached to intestines and mesentery so that which was removed with great caution and secured haemostasis. The mother’s condition was stable throughout the operation and did not need to give the blood transfusion. The sutures were removed after 7 days and the healthy patient discharged from the hospital.Abdominal pregnancy is a rare condition and the diagnosis can be missed during the antenatal period and hence it is crucial to raise the awareness of health care personals especially in remote areas. The suspicious case of abdominal pregnancy should be referred to the experienced clinicians in the centres with diagnosis facilities

Effect of Body Positions on Lungs Volume in Asthmatic Patients: A Cross-sectional Study

Aim: The purpose of our research was to investigate the effect of different body positions on lungs volume by conducting pulmonary function test (PFT) values of the asthmatic patients. The objectives were (1) to assess the correlation between pulmonary function and posture in adult patients with asthma, (2) to determine the best position with higher lungs volume that was preferable for the asthmatic patients to relieve the asthma attack and for rehabilitation approach. Study Design: Cross-sectional study. Place and Duration of Study: This study was conducted in the Reconstructive and Rehabilitative Center at University Malaysia Sarawak (UNIMAS) between December 2015 and June 2016. Methodology: The total of 30 participants was recruited in this study. Among them, 15 participants were asthmatic patients and 15 participants were non-asthmatic, control persons. All theparticipants were between 19-25 years of age and they were enrolled after they had signed a written consent. Participants were selected using the inclusion criteria and Spiro Excel PC based pulmonary function test (PFT Medicaid Systems) were administered. Spirometer measurements (FVC, FEV1) were taken in the standing, sitting and supine positions. Each measurement was taken two times and the average values were analyzed. The order of the body positions was randomized. Results: In the asthmatic group, the best position was supine with a mean±standard deviation (SD) of FEV1/FVC, 77.93±17.37. Whereas, in control group, the best position was standing with a mean±SD of FEV1/FVC, 90.12±5.97. The second best positions were sitting position in the asthmatic group (75.37±16.37) and supine position in control group (89.70±8.79). Finally, the standing position had the lowest lungs function in the asthmatic group (73.63±17.08) and sitting position in control group (88.53±11.17). Conclusion: Our study showed that supine was the best position for measuring FEV1 and FVC of asthmatic participants. Therefore, supportive positions such as supine or leaning to the wall are suggested to improve pulmonary function of the patients, especially during asthmatic attack

Magnesium for treating sickle cell disease

Sickle cell disease is an autosomal recessive inherited haemoglobinopathy which causes painful vaso-occlusive crises due to sickle red blood cell dehydration. Vaso-occlusive crises are common painful events responsible for a variety of clinical complications; overall mortality is increased and life expectancy decreased compared to the general population. Experimental studies suggest that intravenous magnesium has proven to be well-tolerated in individuals hospitalised for the immediate relief of acute (sudden onset) painful crisis and has the potential to decrease the length of hospital stay. Some in vitro studies and open studies of long-term oral magnesium showed promising effect on pain relief but failed to show its efficacy. The studies show that oral magnesium therapy may prevent sickle red blood cell dehydration and prevent recurrent painful episodes. There is a need to access evidence for the impact of oral and intravenous magnesium effect on frequency of pain, length of hospital stay and quality of life

Factors associated with psychological distress among Myanmar residents during COVID-19 pandemic crises

Background: COVID-19 pandemic reached a public health emergency status of international concern. The impacts and events associated with this were associated with adverse psychological impacts among the general public globally. This study aimed to determine the prevalence of psychological distress and to identify predictors associated with psychological distress due to the COVID-19 pandemic among the population in Myanmar. Design and Methods: A cross-sectional survey was conducted from March to April 2020 among adults, 18 years old and above, who reside in Myanmar through a structured questionnaire distributed in social media platforms. Univariate and Bivariate analyses were used to estimate the prevalence of COVID-19 Peritraumatic Distress Index (CPDI) symptoms and to test the associations between CPDI and the exposure variables. Logistic Regression Analysis was done to identify significant predictors of distress. Results: There were 530 participants in this study.37.4% of them did not have psychological distress,55.6% experienced mild to moderate psychological distress, and 7% experienced severe psychological distress due to COVID-19 pandemic. Simple and Multiple Logistic Regression Analyses were performed to determine the factors associated with psychological distress due to COVID-19. Conclusions: It was shown that the self-employed group and age group older than 45 years old had more psychological distress than others. However, Buddhists and people from the capital city had less distress than other religions and districts. This study recommends the government to develop better strategies for self-employed groups, elders, and the poor for a support, relief, and resettlement of their ruined status

Medical students' knowledge and perception toward family planning services: A preliminary intervention study

INTRODUCTION: Family planning and contraception is the effective strategy to reduce maternal mortality, child mortality, abortion, and unwanted pregnancies. Since the medical students are the future doctors, it is important to have proper knowledge and training on family planning services. This study aimed to explore the effect of teaching-learning process at maternal and child health (MCH) clinics on the students' knowledge, perceptions toward contraception methods, and family planning counselling. METHODS: This quasi-experimental study was conducted in the private medical institution in Malaysia. The same questionnaire was used to administer twice, before and after the posting. Moreover, a qualitative question on the issues related to family planning and contraception utilizations in Malaysia was added to the after posting survey. The quantitative data were analyzed using IBM SPSS (version 20) and qualitative data by RQDA software. RESULTS: A total of 146 participants were recruited in this study. Knowledge on contraception method before posting was 5.11 (standard deviation [SD] ±1.36) and after posting was 6.35 (SD ± 1.38) (P < 0.001). Thematic analysis of the students' answer revealed four salient themes, which were as follows: (1) cultural barrier, (2) misconception, (3) inadequate knowledge, and (4) improvement for the health-care services. CONCLUSIONS: The teaching-learning process at the MCH posting has an influence on their perception and upgraded their knowledge. It also reflects the role of primary health-care clinics on medical students' clinical exposure and training on family planning services during their postings

Knowledge and attitude of mandatory infectious disease notification among final year medical students

Background: Disease surveillance is one of the major components to combat against infectious diseases. As health-care professionals are indispensable to mandatory notifiable disease surveillance, their knowledge and attitudes toward infectious disease notification played an important role for timely and effective reporting to the surveillance system. Therefore, we aimed to determine the knowledge of mandatory notifiable infectious diseases in Malaysia and attitude towards infectious disease reporting among final year medical students. Methods: A cross-sectional study was conducted from May to June 2017 in the private medical college in Malaysia. Materials and Methods: We purposively selected the final year (semester 10) medical students and a total of 124 students participated in this study. We collected data using a self-administered, structured questionnaire. Data were analyzed using descriptive statistics, independent t-test, and one-way analysis of variance. Results: Among the final year medical students, 47.5% had moderate knowledge but 4.2% had good knowledge of mandatory infectious disease notification. Only 3.2% of the students correctly answered all the notifiable diseases listed in the questionnaire. Most of the students had positive attitude toward communicable diseases reporting, rewards, and penalty for notification. There was no significant relationship between sociodemographic characteristics and knowledge and attitude of infectious disease notification. Conclusions: The majority of the final year medical students had moderate level of knowledge and positive attitude of infectious disease notification; however, there were some deficiencies. Better instruction and training on infectious disease notification procedures of Malaysia should be provided to the final year medical students which could not only reduce underreporting but also improve timely and effective reporting in future

Essential Thrombocythemia Complicated with Acute Myocardial Infarction

Aims: Essential thrombocythemia or thrombocytosis is an uncommon disease. It involves an overproduction of megakaryocytes in the marrow. These platelets may not function normally and can cause a blockage in blood vessels and other complications. We report one case of essential thrombocytosis with different clinical presentations. Presentation of Case: A 50 year old gentleman came to Hospital and admitted with the diagnosis of Acute Myocardial Infarction. Further investigation via Full Blood Count revealed Essential Thrombocytosis. Management with PCI (Percutaneous Coronary Intervention) and discharged with hydroxyurea. Discussion: We treated our patients with aspirin and hydroxyurea. As similarly noted in follow up of blood complete picture shows that it reduced the platelet count and patient showed much improvement. Conclusion: This case is reported because it is not a common disease and to demonstrate that routine examination of blood complete picture is very important

Knowledge, attitudes, and barriers toward research: The perspectives of undergraduate medical and dental students

Context: Scientific research not only promotes health and combats diseases of an individual, but also it can strengthen the effectiveness of health systems. Hence, understanding of scientific methods becomes a crucial component in the medical profession. Aims: This study was conducted to assess the knowledge, attitudes, and barriers toward research among undergraduate medical and dental students. Settings and Design: This cross-sectional study was conducted among 295 undergraduate Bachelor of Medicine and Bachelor of Surgery (MBBS) and Bachelor of Dental Surgery (BDS) students from a private medical college in Malaysia. Materials and Methods: We purposively selected 360 students attending the 3rd, 4th, and 5th year in MBBS course and BDS course in September 2015. A total of 295 students who were willing to provide written informed consent were included in this study. We collected data using a validated, self-administered, structured questionnaire which included 20 questions about knowledge toward scientific research, 21 attitude items in regard to scientific research, a list of 10 barriers toward conducting medical research, and 5 questions of confidence to conduct the medical research. Statistical Analysis Used: Data were analyzed using descriptive statistics, independent t-test, ANOVA, and multiple linear regression. Results: Among the students, 56.9% had moderate knowledge while the majority (83.3%) had moderate attitude toward scientific research. The majorly cited barriers were the lack of time (79.9%), lack of knowledge and skills (72.1%), lack of funding (72.0%) and facilities (63.6%), and lack of rewards (55.8%). There was a significant association between age, academic year, and knowledge of research as the older age group, and 4th- and 5th-year students had higher knowledge score. The students of higher attitude score had better-perceived barriers score toward research with regression coefficient 0.095 (95% confidence interval 0.032–0.159). Conclusions: Even though the students had the positive attitudes toward scientific research, a supportive and positive environment is needed to improve skills and knowledge of research and to overcome the barriers toward the conduct of scientific research