Aktiviti Falak Sebagai Aktiviti Ko-Kurikulum di Sekolah Menengah dan IPT

Adalah menjadi moto Universiti “bersaing diperingkat dunia” iaitu satu hasrat Universiti untuk melahirkan pelajar-pelajar yang serba boleh, luas pengetahuan, matang dan berfikiran waras dalam semua bidang. Oleh itu, untuk mencapai hasrat ini Pusat Pengajian Sains Perubatan Universiti Sains Malaysia Kubang Kerian telah mengaktifkan kembali aktiviti-aktiviti ko-kurikulum yang selama ini tidak begitu dihiraukan. Dengan kata lain, ianya diharap dapat mengelakkan pembelajaran yang berorientasikan peperiksaan semata-mata yang juga menjadi hasrat kementerian pendidikan sekarang. Dengan ini diharap akan dapat menggalakkan proses pembelajaran yang berterusan sepanjang masa dalam apa apa bidang yang dicebur

Comparison of the use of the laryngeal tube (vbm) and laryngeal mask airway under anaesthesia during spontaneous ventilation

The purpose of this study is to assess whether the newly developed laryngeal tube {VBM) is a fast, reliable and easy device for airway management. We compared the use of the laryngeal tube (VBM) with the laryngeal mask airway in spontaneously ventilating adult patient undergoing general anesthesia and measured the easiness of insertion, incidence of airway trauma and sore throat and also the haemodynamic responses to insertion of these devices. A randomized single blinded prospective study was conducted involving a total of 121 premedicated, ASA 1 or 11 patients, aged 18 to 65 years and were divided into 2 groups either laryngeal tube {VBM) or laryngeal mask airway group as for airway man~gement during elective surgery. After a standardized induction of anaesthesia with fentanyl 1.5 ng.kg-1 and propofol 2 mg.kg-1, a size 3 or 4 laryngeal tube {VBM) or laryngeal mask airway was inserted and the patients breathed spontaneously throughout the surgery with no muscle relaxants given. Anaesthesia was maintained with nitrous oxide, oxygen and isoflurane. The airway device was removed at the end of surgery with the patients fully awake. The speed and ease of insertion and the number of attempts needed to successfully secure the airway were recorded. The incidence of airway trauma, sore throat and haemodynamic changes such as systolic blood pressure, diastolic blood pressure, mean arterial pressure and heart rate at different time intervals were recorded. Episodes of airway manipulations intraoperatively and end-tidal C02 at various time intervals were also recorded. We found that there was no statistically significant difference in time required for successful insertion and number of attempts for both groups. We were able to achieve a clear airway in 75.4% patients in L T group at the first attempt. There were no difference in incidence of airway trauma and sore throat between laryngeal tube and laryngeal mask airway. Both groups had no statistical differences in haemodynamic parameters during spontaneous ventilation under anaesthesia. Although, the incidence of airway manipulations and end - tidal C02 were higher with laryngeal tu~e (~BM) compared to the larynge~l mask airway but it is not likely to be clinically relevant 1n th1s study. We conclude that dunng spontaneous ventilation, the laryngeal tube (VBM) is a suitable alternative to the laryngeal mask airway

Sikap Dan Peranan Pencerap Muslim Semasa Gerhana Menurut Hadith

Gerhana bulan dan matahari merupakan salah satu daripada fenomena astronomi yang menarik. Seluruh dunia menantikan ketibaannya. Pencerap kebiasannya akan datang bagi membuat pemerhatian dan rakaman fenomena ini, dengan sikap dan sambutan yang pelbagai. Di dalam agama Islam, nabi telah meletakkan beberapa panduan bagaimanakah sikap dan peranan pencerap Muslim semasa fenomena tersebut. Kajian ini merupakan satu analisis tematik mengenai sikap dan peranan Muslim semasa berlakunya gerhana matahari

Scalene Myofascial Pain Syndrome Mimicking Cervical Disc Prolapse: A Report of Two Cases

Scalene myofascial pain syndrome is a regional pain syndrome wherein pain originates over the neck area and radiates down to the arm. This condition may present as primary or secondary to underlying cervical pathology. Although scalene myofascial pain syndrome is a well known medical entity, it is often misdiagnosed as being some other neck pain associated with radiculopathy, such as cervical disc prolapse, cervical spinal stenosis and thoracic outlet syndrome. Because scalene myofascial pain syndrome mimics cervical radiculopathy, this condition often leads to mismanagement, which can, in turn, result in persistent pain and suffering. In the worst-case scenarios, patients may be subjected to unjustifiable surgical intervention. Because the clinical findings in scalene myofascial pain syndrome are “pathognomonic”, clinicians should be aware of ways to recognize this disorder and be able to differentiate it from other conditions that present with neck pain and rediculopathy. We present two cases of unilateral scalene myofascial pain syndrome that significantly impaired the patients’ functioning and quality of life. This case report serves to create awareness about the existence of the syndrome and to highlight the potential morbidity due to clinical misdiagnosis

Inappropriate Doses of Intravenous Polymyxin B after Renal Adjustment Lead to Treatment Failure

Sub-therapeutic doses, shorter duration of therapy, female gender, bacteremia, and renal impairment were among independent predictors of polymyxin B treatment failure. In this study, we found an association between inappropriate doses of polymyxin B (<15000 or >25000 unit/kg/day) and renal impairment. Inappropriate doses of polymyxin B were significantly associated with CrCl 20-50 mL/ min (p = 0.021, ORadj 6.660, 95% CI 1.326, 33.453) and CrCl <20 mL/min (p = 0.001, ORadj 22.200, 95% CI 3.481, 141.592). By conducting sub-group analysis only using subjects with appropriate dosage, renal impairment was not associated with polymyxin B treatment failure, thus indicating that treatment failure was due to an inappropriate dose of polymyxin B, rather than renal impairment. In conclusion, renal impairment was not directly associated with treatment failure but was due to an inappropriate dosage of polymyxin B after renal adjustment

Predictors of polymyxin B treatment failure in Gram-negative healthcare-associated infections among critically ill patients

Background: With increasing prevalence and spread of multidrug resistant Gram-negative infections, parenteral polymyxins resurged in clinical practice. The primary aim of the study was to determine the predictors of treatment failure and in-hospital mortality among critically ill patients treated with polymyxin B. Methods: Demographic data, underlying diseases, procedures and details on polymyxin B therapy were retrospectively analyzed in a cohort of 84 patients who received intravenous polymyxin B in an intensive care unit from 2010 to 2014. Results: Polymyxin B was used to treat bacteremia (46.4% of cases) and pneumonia (53.6%). Majority of the pathogens isolated were Acinetobacter spp. (96.4%). The mortality rate was 48.8%, of which 82.9% was attributed to polymyxin B treatment failure. The independent predictors of treatment failure were low doses of polymyxin B (p = 0.002), shorter duration of therapy (p = 0.009), not combining with cefoperazone/sulbactam (p = 0.030), female gender (p = 0.004), administered for treatment of bacteremia (p = 0.023) and renal impairment (p = 0.021). Low polymyxin B doses (p = 0.007), not combining with cefoperazone/sulbactam (p = 0.024), female gender (p = 0.048) and renal impairment (p = 0.022) were also significant predictors for in-hospital mortality. Conclusions: To the best of our knowledge, this is the first report on the association of inadequate dose of polymyxin B (<15,000 units/kg/day) with poor outcome in critically ill patients. Besides that, further clinical studies are warranted to evaluate the use of cefoperazone/sulbactam as second antibiotic in the combination therapy. Keywords: Polymyxin B, Critically ill patients, Acinetobacter spp., Treatment failure, Adequate dose, Cefoperazone/sulbacta

A case report: community-acquired Pseudomonas aeruginosa necrotizing fasciitis in a morbidly obese diabetic young man can be fatal

We present a case study of a 26-year-old morbidly obese man with a three-day history of right leg pain and swelling. The swelling was associated with low grade fever. He was alert and conscious upon presentation to the hospital. His physical examination showed gross swelling of the entire right lower limb with no systemic manifestations. There was no discharge and bullae from the swelling area of the leg. He had high blood sugar and was newly diagnosed with type 2 diabetes mellitus. He was diagnosed with necrotizing fasciitis. An intravenous imipenem-cilastatin 500 mg every 6 h together with clindamycin 900 mg every 8 h was started empirically. Extensive wound debridement was performed. The swab culture obtained intraoperatively grew\ua0Pseudomonas aeruginosa.\ua0He required an above knee amputation due to worsening infection despite wound debridement. Post-operatively, he developed acute kidney injury with severe metabolic acidosis, which required daily hemodialysis. However, the patient deteriorated due to septic shock with multi-organ failure, resulting in his death