A Preliminary Study Of The Influence Of HIV Infection In The Transmission Of Tuberculosis.

The human immunodeficiency virus (HIV) epidemic has had a profound influence on the epidemiology of tuberculosis (TB). The potential for HIV-associated TB cases to transmit M. tuberculosis and to produce a secondary increase in TB morbidity is unknown

Erectile dysfunction among diabetic patients in Kota Bharu Kelantan

A cross sectional study was conducted among diabetic patients in Kelantan, Malaysia to determine the prevalence of erectile dysfunction (ED),characteristics of diabetic patients with ED and patient's knowledge, attitude and practice towards ED. A total of 156 patients from Diabetic Clinic, Klinik Kesihatan Bandar, Kota Bharu and Hospital Universiti Sains Malaysia (USM), Kubang Kerian were selected into the study by using the availability sampling technique. Respondent were given self-administered questionnaire. ED was determined by using the International Index Of Erectile Function (IIEF-5). Statistical Program for Social Science (SPSS) version 9.0 was used for analyzing the data. The mean age was 53.2 ± 9.18 year. Majority of patients were Type 2 diabetes (97.6%). The overall prevalence of ED was 77.8% in which the prevalence of severe ED was 36.7%. There was significant correlation between age, duration of diabetes, history of smoking and retinopathy with ED (p0.05). Majority of patients (86%) had poor knowledge regarding ED.On comfort discussing about ED with the health provider, 18.2 % felt very comfortable, 32.5% felt comfortable, 15.9% felt quiet comfortable, 15.1% felt between comfortable and uncomfortable, 15.9% felt uncomfortable and 2.4% felt very uncomfortable. Regarding seeking treatment, 57.1% would do so. This study showed a high prevalence of ED in diabetic patients. The main factors associated with ED were age, duration of diabetes, history of smoking and retinopathy. Patients also considered the information on nature of ED and possible treatment were scant and generally inadequate

A Multi - Centered Study Of The Influence Of Hiv Infection On The Transmission Of Tuberculosis To Household Contacts Three States Of Malaysia.

A multi-centered cross-sectional study was carried out to examine tuberculin (Mantoux) response among household contacts of pulmonary TB (PTB) patients registered in Kota Bharu Hospital, Kelantan; Alor Setar Hospital Kedah and Institute of Respiratory Medicine, Kuala Lumpur from year 2000 through 2004

Predicting length of stay in patients admitted with acute upper gastrointestinal bleeding using Rockall score

Introduction Rockall score was originally developed to predict mortality from AUGIB. However, there have been studies advocating its use to predict endoscopic/surgical intervention and length of hospital admission. We analyzed if length of hospital stay can be predicted from the preendoscopy and/or post-endoscopy Rockall score

Pancreatic Metastases from Ovarian Carcinoma - Diagnosis by Endsocopic Ultrasound-Guided Fine Needle Aspiration

Pancreatic metastases are very uncommon and originate most commonly from lung, colon, breast and kidney cancer. Ovarian adenocarcinoma has been reported as a primary site of pancreatic metastasis, but its diagnosis has rarely being reported by endoscopic ultrasound guided fine needle aspiration (EUS-FNA). We report a case of multiple metastases to the pancreas from ovarian carcinoma occurring four years after original resection of the primary tumour. Our patient presented with severe epigastric pain which was initially treated as acute pancreatitis. Further imaging modalities showed multiple large pseudocystic lesions in the pancreatic head and body. Subsequent EUSFNA confirmed that the lesions were metastatic disease from an advanced ovarian carcinoma. She underwent palliative chemotherapy and the pancreatic lesion showed receding size

Patient satisfaction toward medical ward services in a Teaching Hospital (TH) and a General Hospital (GH)

A contrived cross-sectional study was conducted among medical inpatients admitted to the medical wards of a Teaching Hospital (TH) and a General Hospital (GH) in the Kota Bharu district to study patient satisfaction toward medical ward services in both hospitals. A validated, self-administered patient satisfaction toward medical ward service (PSMWS) questionnaires were given to 376 eligible medical inpatients. This study showed that demographic characteristics of two groups were similar except median family income higher among TH group (RM925 vs. RM775, p<0.05), median PatientS Out-of-Pocket Expenditure (POE) was higher among TH group (RM3j vs. RM28, p<0.001), mean Length of Stay (LOS) was longer among TH respondents(j.8 vs. 3.3 days,

Wernicke's Encephalopthy associated with hyperemesis gravidarum - A CASE REPORT

Two cases of Wernicke's encephalopathy due to hyperemesis gravidarum are described. The first patient presented with bilateral papilloedema, altered sensorium and the second with bilateral retinal haemorrhages, ophthalmoplegia and nystagmus. Both patients were diagnosed with Wernicke's encephalopathy on clinical ground since there were no laboratory facilities to measure red cell transketolase and thiamine pyrophosphate levels. This is a rare but treatable complication of hyperemesis gravidarum (HG) and due to lack of diagnostic tools, there is often diagnostic uncertainty, delay in commencing appropriate treatment, as well as irreversible damage to the upper brain stem and death

Pancreatic metastases from ovarian carcinoma—diagnosis by endoscopic ultrasound-guided fine needle aspiration

Pancreatic metastases are very uncommon and originate most commonly from lung, colon, breast and kidney. Ovarian adenocarcinoma has been reported as a primary site of pancreatic metastasis, but diagnosing using EUS-FNA is rarely being reported. Case report We reported a case of multiple metastases to the pancreas from ovarian carcinoma occurred 3 years after original resection of the primary tumour. A 60 year-old lady with prior history of stage IIIC ovarian carcinoma was referred to the Gastroenterology Unit for the evaluation of multiple pancreatic mass. She was diagnosed with the malignancy 3 years earlier and had undergone total abdominal hysterectomy and bilateral salphingo-oophorectomy. She presented with severe epigastric pain associated with nausea and mass per abdomen. She was treated as acute pancreatitis based on clinical and biochemical results. Initial trans-abdominal ultrasound showed multiple pseudocyst within the pancreas, with the largest measuring 4.7 × 3.6 cm. Similar fi ndings were noted from CT scan of the abdomen. EUS revealed multiple cystic lesions with heterogenous appearance at the head and body of the pancreas. Endoscopic ultrasound guided fi ne needle aspiration (EUS-FNA) was performed and the result showed pancreatic papillary adenocarcinoma which was morphologically identical to the surgical specimen of her ovarian mass. She was then treated with palliative chemotherapy. Conclusion EUS-FNA in conjunction with immunohistochemistry is a useful tool for diagnosing pancreatic lesion and mass. Although pancreatic metastases are rare, we still need to exclude the diagnosis for any pancreatic lesion

Steatohepatitis and fibrosis in chronic Hepatitis C patients: is there any association?

Background: Hepatic steatosis and disturbances in lipid metabolism has been identified as one of the metabolic disorders in hepatitis C (HCV) infection. This study was to examine the possible association of steatohepatitis with the degree of fibrosis in chronic HCV patients. Methods: Retrospective analysis of data from 72 patients with chronic HCV who underwent liver biopsy from January 2008 to March 2010 in two tertiary hospitals in Malaysia was performed. Patients’ demographic data and their body mass index (BMI), liver function tests and lipid profiles, histological findings of steatosis,staging and grading of biopsy specimen were made. Staging and grading of liver disease was done using modified histological activity index staging (score 0–6) and grading (score 0–18) respectively.Univariate analysis was done to assess the association between the degree of fibrosis and steatohepatitis. Results: 79.2% were males and the mean age for the study population was 40.7 ± 12.0 years. There were 13.9 and 9.7% cases of coinfection with HIV and hepatitis B respectively, while 76.4% patientswere infected with HCV alone. The table showed the superimposed steatohepatitis that was present with severe fibrosis and mild or no fibrosis in the two different groups. However, the univariate analysis assessing the association between the degree of fibrosis and the presence of steatohepatitis in both the two groups could not find any significant result. Conclusion: There was no significant association between steatohepatitis and the degree of fibrosis in patients with chronic HCV infection, either co-infection with other viruses or HCV infection alone