Progressive Enlarging Blind Spot in a Young Asian Lady: A Case Report on Acute Zonal Occult Outer Retinopathy

Acute Zonal Occult Outer Retinopathy (AZOOR) is a very rare retinal disease that predominantly affect the Caucasians. It is usually present in a young myopic woman with an acute onset of photopsia and enlarging blind spots. Here, we report a young Asian lady who presented with a typical presentation of AZOOR and later confirmed by electrophysiological test of the retina. She was wrongly diagnosed as retrobulbar optic neuritis due to low index of suspicion for AZOOR among the treating physicians in the hospital. Fortunately, she responded to systemic corticosteroid that was given as a treatment of optic neuritis. AZOOR was only diagnosed later by a visiting European neuro-ophthalmologist in a neighboring country. The objective of this case report is to remind the reader that the condition exists in Asian population and should be kept as a differential diagnosis in a young lady who presented with progressive visual field defect

Progressive Enlarging Blind Spot in a Young Asian Lady: A Case Report on Acute Zonal Occult Outer Retinopathy

Acute Zonal Occult Outer Retinopathy (AZOOR) is a very rare retinal disease that predominantly affect the Caucasians. It is usually present in a young myopic woman with an acute onset of photopsia and enlarging blind spots. Here, we report a young Asian lady who presented with a typical presentation of AZOOR and later confirmed by electrophysiological test of the retina. She was wrongly diagnosed as retrobulbar optic neuritis due to low index of suspicion for AZOOR among the treating physicians in the hospital. Fortunately, she responded to systemic corticosteroid that was given as a treatment of optic neuritis. AZOOR was only diagnosed later by a visiting European neuro-ophthalmologist in a neighbouring country. The objective of this case report is to remind the reader that the condition exists in Asian population and should be kept as a differential diagnosis in a young lady who presented with progressive visual field defect

Prevalence of chronic kidney disease among community remote areas in Sabah: Population-Based Study

In this population-based study, we determined the prevalence of chronic kidney disease (CKD) of community in remote areas of Ranau, Sabah to have accurate information for health-care planning. It also investigated the association of risk factors with the prevalence of CKD. A sample of 270 individuals, compared to the study of the National Health and Morbidity Survey 2011, of the adult population (over 18 years old) undertaken in West Malaysia. We measured the estimated glomerular filtration rate (eGFR) using this CKD-EPI equation. The total prevalence of CKD in this group was 53%. An estimated 3.3% had stage 1 CKD (eGFR >90 ml/min per 1.73m2), 32.6% had stage 2 (eGFR 60–89 ml/min per 1.73m2), 4.1% had stage 3 (eGFR 30–59 ml/min per 1.73m2), 7% had stage 4 (eGFR 15–29 ml/min per 1.73m2), and 6% had stage 5 CKD (eGFR <15 ml/min per 1.73m2). Only 4% of respondents with CKD were aware of their diagnosis. The significant risk factors included family history of kidney disease, alcohol consumption, smoking status, hypertension, diabetes mellitus, and dyslipidemia. Thus, CKD in East Malaysia are common and warrants early detection, and treatment to potentially improve outcomes can be implemented

The Association of Foot Care Strategies (FCS) through Ablution with Hba1c among Diabetes Mellitus Type 2 Patient

Diabetes Mellitus in Malaysia has become increasingly problematic along with issues of other cardiovascular conditions such as hypertension, heart disease and stroke. Therefore, the aim of this study is to determine the association of Foot care strategies (FCS) through ablution with Hba1c result among Diabetes Mellitus Type 2. The study design used is a Quasi experimental design. The intervention group received an Educational Package that focused on ablution, while the control group did not receive any form of intervention and received standard health care. A Wilcoxon test was used for the statistical analyses. There are no statistical changes in the mean difference of score in intervention and control group after implementation of Diabetic Foot Care Strategies for intervention group Pre-test (M=7.706, SD=2.598, P 1.000) and Post-test is (M=7.706, SD (2.598), P 1.000). It was found that 0% Changes from baseline to post test. In this study has found that there was no effect between the improvement of foot hygiene with Hba1c result even though respondent Hba1c result were well control and poorly control

SARS-CoV-2 infection of the nervous system: A review of the literature on neurological involvement in novel coronavirus disease-(COVID-19)

The novel coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is believed to have emerged from an animal source and has been spreading rapidly among humans. Recent evidence shows that SARS-CoV-2 exhibits neurotropic properties and causes neurological diseases. Here, we review the literature on neurological involvement in SARS-CoV-2 infections and the possible mechanisms of invasion of the nervous system by this virus, to provide a summary and critical analysis of the early reporting of neurological involvement in COVID-19. An exhaustive search of scientific articles on neurological involvement in COVID-19 was performed in the Web of Science, Scopus, Medline/PubMed, and several other databases. Nineteen relevant articles that had been published or were in preprint were carefully selected according to the inclusion and exclusion criteria. Based on our research, we found that patients with COVID-19 can present with neurological symptoms that can be broadly divided into central nervous system involvement, such as headache, dizziness, altered mental state, and disorientation, and peripheral nervous system involvement, such as anosmia and hypogeusia. Most of these patients are in the older age group and exhibit comorbidities, especially hypertension, and severe infection. In extreme presentations of COVID-19, some patients exhibit seizures, stroke, flaccid paraparesis, corticospinal weakness, and even coma. Moreover, the neurological man-ifestations can occur independently of the respiratory system. In conclusion, SARS-CoV-2 infection can cause multiple neurological syndromes in a more complex presentation. Therefore, this review elucidated the involvement of the nervous system in SARS-CoV-2 infection and will hopefully help improve the management of COVID-19

The Quality of Life Among Nursing Students Related to Stress and Academic Pressure in North Borneo Local University

Nursing students often face high levels of stress and academic pressure due to the demanding nature of their coursework, clinical rotations, and the responsibility of caring for patients. Therefore, the aim of this study is to identify the association between Quality of Life and stress plus academic pressure among nursing student in north Borneo local university. Material and Method – Cross sectional study design was used, with 55 respondents using Academic Pressure Scale (APS) and Overall Quality of Life scale (WHOQOLS) as the questionnaire was analyse using Chi-square test. Result – The probability value obtained from Pearson ChiSquare was 0.014 is less than predetermined alpha value (0.05), thus the null hypothesis was rejected. Conclusion: There is significant association between WHOQOL and the APS underscores the interconnectedness of students' perceived quality of life and their experience of academic stress

Cranial Diabetes Insipidus in Neuropsychiatric Systemic Lupus Erythematosus, a Rare but Treatable Association: A Case Report

Systemic lupus erythematosus has been rarely reported to be associated with cranial diabetes insipidus. It is a condition clinically manifest as severe polyuria and reactive polydipsia that may lead to electrolyte imbalance or acute kidney injury as a result of arginine vasopressin insufficiency. Here, we report a patient with systemic lupus erythematosus and lupus nephritis previously under control with medication presented with neuropsychiatric symptoms which responded to pulsed methylprednisolone, developed severe polyuria, polydipsia and hypernatremia which persisted after pulsed therapy. Serum and urine osmolarity were suggestive of diabetes insipidus and the polyuria resolved dramatically after trial of oral desmopressin which in keeping with the diagnosis of central cause. The objective of this case report is to share the uncommon occurrence of diabetes insipidus in neuropsychiatric systemic lupus erythematosus

Unusual presentation of Cerebral lupus: A case report of Parkinsonism in Cerebral lupus

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with multisystem involvement that follows a relapsing and remitting course. It is characterized by an immune-mediated response to own body defense mechanism and mistakenly attacked healthy cells of the skin, joints, kidneys, blood cells, and nervous system. Cerebral lupus refers to a constellation of neurological and/or behavioral clinical syndromes in patients with SLE. The spectrum of presentation can vary widely ranging from mild symptoms such as headaches, slight cognitive dysfunction, and mood disorders to more serious conditions like seizures, stroke, or coma. This case report is about a case of cerebral lupus manifested with symptoms of Parkinsonism. The purpose of this case report is to share an uncommon occurrence of cerebral lupus which manifested as Parkinsonism and to highlight the importance of early diagnosis of the condition which is potentially reversibility with prompt

An uncommon cause of myalgia: A case report on systemic lupus erythematous myopathy

Introduction: Myositis in systemic lupus erythematous may present in a wide range of clinical spectrum. It can be part of an overlap syndrome, or mixed connective tissue disease or a musculoskeletal manifestation of systemic lupus erythematous itself. Case presentation: Here, we present a young girl with an underlying systemic lupus erythematous presented with the typical manifestation of severe proximal myopathy in the background of normal creatine kinase values. The diagnosis of systemic lupus erythematous myopathy was made after excluding other more common causes of myopathies which in itself is a very rare occurrence. Discussions: A normal creatine kinase values does not exclude systemic lupus erythematous myositis but make the diagnosis more challenging. However, there are other parameters or diagnostic tools which can be used to exclude a myositis

A Case Report on Core Muscles Training for Knee Osteoarthritis Through Core Muscles Activations and Gait Analysis

Knee osteoarthritis (OA) is a chronic joint disease that can affect all ages, but it is more common in the elderly. Pharmacological and non-pharmacological treatments have been invented evolutionarily over the years to halt this disease. Exercise is one of the first-line treatments for knee OA as well as for prevention. This case study features a 47-year-old man who has grade IV bilateral knee OA and has never had any surgery and takes fish oil daily as a supplement. His walking pattern was significantly impacted by the chronic knee discomfort he had in both legs. Thus, the walking gait of this patient was analyzed together with core muscle activation before and after two weeks of core resistance exercise intervention. The knee pain score was assessed using the Western Ontario and McMaster Universities Index (WOMAC). The outcomes of this research depict that core resistance training has the potential to be used as an alternative, non-surgical and non-pharmacological treatment for a patient with knee OA