Intraosseous lipoma of the calcaneum: a rare cause of heel pain

Heel pain is a common presentation at any outpatient clinic. Heel pain may originate from either bone or the surrounding soft tissues. Tendo achilles tendinitis and plantar fasciitis are the two most common causes of heel pain. We report a case of an uncommon condition presenting through a common presentation at the primary care clinic, i.e., an intraosseous lipoma of the calcaneum presenting through heel pain. This tumour constitutes 0.1% of benign bone tumours and is 8% prevalent in the calcaneum bone

Maternal satisfaction towards intrapartum care of designated healthcare facilities and its associated factors among postnatal women attending Klinik Kesihatan Salak

Introduction: The World Health Organization recommends evaluation of maternal satisfaction to improve quality of health care during childbirth. Dissatisfaction may lead to undesired outcomes such as unassisted homebirth and delay in seeking treatment. Determining the maternal satisfaction level and its associated factors may help to improve health care services and prevent negative implications to both mothers and infants. This study aimed to determine the maternal satisfaction towards intrapartum care of designated healthcare facilities and its associated factors among postnatal women. Methods: This was a cross-sectional study of postnatal women attended Klinik Kesihatan Salak from December 2017 to February 2018. Systematic random sampling with the ratio of 1:3 was applied to the eligible respondents. A self-administered questionnaire that include respondent’s socio-demographic characteristics and a validated 14-items Maternal Satisfaction with Hospital-based Intrapartum Care Scale was used. Data was analyzed using SPSS 23. Results: 274 respondents were recruited in this study. Overall, only 21.2% of respondents were satisfied with the intrapartum care given. The level of satisfaction was highest in interpersonal care domain (36.1%), followed by physical birth environment (34.3%) and the least satisfied was information and decision making domain (27.7%). Binary logistic regression showed that maternal satisfaction was significantly associated with place of birth (AOR (95% CI): 0.046 (0.183, 0.984)) and labour complications (AOR (95% CI): 3.387 (1.345, 8.528)). Conclusion: The overall maternal satisfaction towards intrapartum care was low and the information and decision-making domain appeared to be the least satisfied. Maternal satisfaction was associated with place of birth and labour complications. Therefore, health care providers should emphasize and improve the quality of services especially for this domain and to consider factor that contribute to dissatisfaction towards the intrapartum care

A rare variant of knee dislocation

Knee dislocation is a rare injury. It represents less than 0.2% of orthopaedic injuries. This case reports a rare form of knee dislocation caused by the impact of a high-energy trauma. In these cases the appropriate assessment and management is needed to ensure that patient receives the proper treatment

Anterior inferior iliac spine fracture: another component of selt belt syndrome?

Seat belt syndrome occurs when seat belts are used improperly, and it is a cause of significant morbidity and mortality. The spectrum of seat belt syndrome includes spinal, intra-abdominal and vascular injury. Here, we report the case of anterior inferior iliac spine avulsion fracture in association with seat belt injuries in a 24-year old man involved in a head on motor vehicle collision

Degenerative osteophyte causing acute locked knee in a young man: a case report

Acute locked knee is usually caused by mechanical blockage. We report an unusual case of a locked knee due to tibial osteophyte in a young man following a sport injury. To the best of our knowledge, there has been no previous report describing the same etiology. This case report emphasizes the need for thorough history taking and careful assessment to aid us in the diagnosis. The findings made by arthroscopy confirmed our diagnosis

Bodyweight status misperception among reproductive-aged women in primary care settings

Introduction: It is common, and many international and local studies confirm this, that women of reproductive age misperceive their body-weight status. This phenomenon can lead to their being less likely to adopt a healthy lifestyle which later exposes them to increased health problems and risks including those of a gynecological and obstetric nature. Generally, there have been inconsistent findings concerning the association between the self-perceived weight status and sociodemographic factors, physical activities, and previous weight loss attempts of women of reproductive age in an Asian population like Malaysia. Objective: This study aimed to determine the factors associated with body weight status misperception among reproductive-aged women at a primary care setting in Malaysia. Methods: This is a cross-sectional study conducted at Klinik Kesihatan Durian Tunggal in 2016-2017. The questionnaire included questions on the perception of weight status, sociodemographic factors, smoking status, level of physical activity, and weight loss attempts. Logistic regressions were used for statistical analysis to examine the association between body weight status misperception and related factors. Results: The study recruited 630 reproductive-aged women. The mean age and SD of the respondents was 32.7 + 8.9 years, and 84% of the respondents were Malays. More than three-quarters of the respondents (75.5%, n = 476) had received up to a secondary level of education. The majority of the respondents were in the overweight/obese group (59.4%, n = 374). The mean BMI of the respondents was 27.1 kg/m2 + 6.61. Approximately 65.4% (n = 412) of the respondents had an inactive lifestyle. However, 60% (n = 378) of the respondents reported that they had attempted to reduce their weight in the last year. A total of 141 respondents (22.4%) misperceived their weight status with 113 (80.1% ) of them underestimating their weight status. Women with primary-level education (OR: 3.545, 95% CI: 1.530-8.215, p = 0.003) and secondary-level education (OR: 1.933, 95% CI: 1.065-3.510, p = 0.030) had a greater likelihood of misperceiving their body weight status as compared to those who have a tertiary level of education. Women with no weight loss attempts were also at risk of body weight status misperception (OR: 1.850, 95% CI: 1.195, 2.865, p = 0.006). Conclusion: Bodyweight status misperception among reproductive-aged women was associated with a low level of education and with those who had made no weight loss attempts. Identifying women who are at risk of misperceiving their weight status would enable early counseling on weight management

Quasi-experimental study on the effectiveness of a house officer preparatory course for medical graduates on self-perceived confidence and readiness: a study protocol

Introduction Being a house officer (HO) is said to be associated with high levels of stress, leading to mental health problems and sometimes to quitting the medical profession altogether. In Malaysia, the number of HOs completing training on time is slowly declining, with increasing annual dropout rates. Feeling incompetent is one of the contributors towards this growing problem. This study aimed to evaluate the effectiveness of a 3-day pre-HO intervention module in addressing participants’ confidence, readiness and psychological well-being in preparation for their HO training.Methods and analysisThe pre-HO intervention is the ‘Medicorp’ module that includes clerkship, experience sharing, hands-on skills training, common clinical cases and introduction of the local healthcare system. This is a pre-post quasi-experimental study lasting 1 year, with three assessment time points—at pretraining, immediately after training and 1 month into the participants’ HO-ship. The study is currently ongoing and involves 208 participants who attended the course in Malaysia. Participants with known psychiatric illness, working HOs and medical students are excluded. A pretested, self-administered questionnaire that includes baseline sociodemography, adaptation of the International Medical University (IMU) Student Competency Survey and the Depression Anxiety Stress Scale has been adopted, and 1 month follow-up will be conducted by telephone. Data will be analysed using SPSS V.24. The primary outcome is change in confidence level, while the secondary outcomes are changes in the readiness and psychological well-being of the participants.Ethics and disseminationThis study protocol has received ethics approval from Ethics Committee for Research Involving Human Subjects Universiti Putra Malaysia and the National Medical Research Registry Malaysia. Written informed consent has been obtained from each participant. Results will be disseminated through journals and conferences, especially those involved in medical education specifically looking into the training of medical doctors

Stress fracture of the femoral neck: a typical cause of hip pain

As femoral neck stress fracture is a rare condition, it is often initially missed diagnose. This case report describes it in a lady with sedentary lifestyle following sudden strenuous exercise which presented with acute hip pain. Without high index of suspicion, fracture can be displaced further and its sequelae such as non-union, malunion and avascular necrosis are often disabling.Stress fracture is a rare condition. It is more common in the tibia, navicular, metatarsal and fibula while femoral neck only occupies 5% from the total cases. Hence, it is uncommon and may pose as a diagnostic challenge. It occurs in individuals that exert force or repetitively apply force to the healthy bone, commonly in athletes and military recruits with repetitive high intensity exercises and training. Due to this load, the bone undergoes a surge amount of bone resorption, however with strenuous activity and lack of rest in between, bone formation is unable to compensate the loss thus leading to microfracture. A break in the cortex may occur with the continuous stress

HIV, homosexuality and depression – challenges at primary care: a case report

Human Immunodeficiency Virus (HIV) is a chronic lifelong infectious disease that greatly impairs the quality of life. HIV and men who have sex with men (MSM) are seen to be synonyms to each other and both were shown to be the risks for depression. This case report is about a homosexual man who contracted HIV via the MSM activity. Being both homosexual and HIV-infected had given him a lot of negative impacts, stigma and discrimination, which drove him into having major depressive disorder. Having depression with underlying HIV and homosexuality has made this case complicated and challenging, especially when it has to be managed at the primary care level