Hepatic involvement in extra-pulmonary tuberculosis (TB) is rare, even in the endemic area. It has a high mortality rate as it can easily be misdiagnosed due to its rarity and non-specific presentations, and the treatment can be challenging for its hepatotoxic side-effect. A 55-year old man who was newly diagnosed with AIDS and pulmonary TB which complicated with anti-TB-induced transaminitis, presented with a few weeks history of fever and persistent diarrhoea. It was initially treated as microsporidia infection but the symptoms persisted despite given antiparasitic agent for more than a week. He was subjected to computed tomography (CT) scan of the abdomen and noted multiple hypoechoic lesion at multiple segments of the liver, which later confirmed to be liver TB by liver biopsy. As he could not tolerate Akurit-4 (Rifampicin 150 mg, Isoniazid 75 mg, Pyrazinamide 400 mg and Ethambutol 275 mg), the second-line treatment was given instead. He is currently well on regular clinic appointment. The objective of this case report is to share the rare occurrence of hepatic TB and the difficulty to treat it as the hepatotoxic effect of anti-TB medications complicate the liver damage due to the infection.
Antiphospholipid syndrome is a hypercoagulable autoimmune condition that predominantly affect the female and commonly manifest as arterio-venous thrombosis and recurrent miscarriage. Here, we present a unique case of a healthy young man who developed sudden onset of right leg swelling after exercise which was then found to be due to deep vein thrombosis via Doppler ultrasound. His blood investigations showed thrombocytopenia and prolonged coagulation profile. Therefore, antiphospholipid syndrome was suspected and later confirmed by positive autoim- mune antibodies. He was treated with long term moderate intensity oral warfarin. The objective of this case report is to share the uncommon occurrence of an unprovoked deep vein thrombosis secondary to antiphospholipid syn- drome in a healthy young man so that the possibility of deep vein thrombosis should be suspected in selected cases of non-resolving leg swelling after exercise as it can lead to fatal pulmonary embolism.
Introduction:The increasing prevalence of childhood obesity among primary school children is a growing public health concern worldwide. Previous study in West Malaysia showed a prevalence of obesity with an estimated of 6.6% among 7-year-olds children and rising to 13.8% among 10-year-olds children. However, no study has ever been conducted in East Malaysia on childhood obesity. This study was aimed to determine the prevalence of child-hood obesity and to investigate the association of physical activity levels with obesity and its intervention among primary school children in Kota Kinabalu. Methods: A cross-sectional study involving 484 students (aged 7-12 years old) was conducted in five primary schools at Kota Kinabalu, Sabah. The schools were selected based on cluster sampling method and simple random sampling method. Primary school children with a known medical condition such as bronchial asthma, type-1 diabetes mellitus or those with a prolonged use of oral steroids was excluded from the study. Self developed questionnaires were used to record sociodemographic details and anthropometric mea-sures both parents and children, and physical activity was measured using a Children Physical Activity Questionnaire (C-PAQ). The intervention involved 3 components; I) motivational interviewing, ii) brief and focused advice, iii) ac-tivity session. Follow up was done 3 months after the intervention was conducted. Results: The prevalence of child-hood obesity among primary school children is 13.2%. There is a negative correlation between children’s BMI and amount of physical activity (-0.347) and positive correlation between children’s BMI and amount of non-physical activity (0.339). Little changes in the BMI of the children after intervention, t(127)= 2.866, p=0.005. Conclusion: This study provides evidence that childhood obesity is not a prevalent health problem in Kota Kinabalu and has proved that physical activity levels have significant associations with children’s body mass indices.
Introduction: Nutrition is an issue of great academic and public importance. However, there is evidence that parents do not have family breakfast, lunch or dinner with their children. This study aims to assess the prevalence of having regular family breakfast, lunch, dinner among primary school children age 7 to 12 years in Kota Kinabalu and its association with children’s weight status. Methods: The study is based on 485 children (mean age: 11.5+/-0.7 years, 54% girls) randomly selected in five primary schools in Kota Kinabalu who participated in a cross-sectional school- based survey in 2019. Data on family meals were self-reported by the parents by answering a validated question- naire. Children’s height and weight were measured to determine BMI status. Binary regression analyses assessed the associations of having regular family meals with children’s obesity status and to assess potential differences in having family meals according to gender and parental education. Results: The mean BMI male gender 24.3 ± 4.05 versus mean BMI female gender 17.9 ± 3.62 from 7 to 12 years old. The father mean BMI was 33.2 ± 8.24 versus 26.17 ±
9.63 mean BMI in mother from 32 to 52 years old. The prevalence of obesity within five (5) selected schools in Kota Kinabalu was only 13.2%. Regarding potential socio-demographic determinants, children of higher educated parents (STPM, DIPLOMA)[OR = 1.85 (95% CI 1.20–2.85)] were more likely to have breakfast together, while children of lower educated parents (SRP, SPM) [OR = 1.08 (95% CI 0.91–1.44)] were more likely to have dinner together. No significant associations of having family meals with gender observed. The prevalence of regular family meals was 94.6%, 74.17% and 93.8% for breakfast, lunch and dinner respectively. Conclusion: This study showed that having regular family breakfast, lunch and dinner was associated with children normal BMI between 18.50-24.99.
Dysmenorrhea is one of the leading causes of pelvic pain and menstrual disorder among women during childbearing age. The burden of dysmenorrhea is greater than any other gynaecological complaint. Some women have severe dysmenorrhea which renders them incapacitated for days each menstrual cycle requiring absence from study or duty, frequently requiring pain killer, restriction of daily performance, poor sleep, negative moods such as anxiety and depression. A 31-year-old female presented with severe dysmenorrhea and heavy menstrual bleeding (HMB) as a cause of multiple uterine fibroids, underwent surgeries to remove 100 fibroids from her uterus which has improved her quality of life, eliminating her dysmenorrhea and menstrual abnormalities
Introduction:Alcohol is a major factor that can affect many aspects of life. The prevalence of current drinker in Malaysia aged 13 years old and above was 7.7% as reported by NHMS 2015. Sabah was ranked the third in highest consumption of alcohol in Malaysia, at 18.4% after Kuala Lumpur 20.3% and Sarawak 19.7%. The aim of the study is to investigate prevalence of different types of drinkers and identify demographic characteristic of drinkers in Kota Kinabalu (KK). This study also aims to investigate the effectiveness of screening and brief intervention in reduction of alcohol consumption and risky drinking in KK. Methods: A cross-sectional study was done where the data were col-lected from seven different areas in KK, selected by stratified and simple randomized sampling. Alcohol Use Disorder Identification Test (AUDIT) questionnaire translated and validated in Malay version by Unit Terjemahan Universiti Malaya was used. AUDIT score was calculated and brief intervention was given accordingly and scoring was then repeated after three months. The intervention applied was based on Guideline on Risk Assessment and Primary In-tervention in Alcohol Harm, published by Ministry of Health Malaysia in 2010. Results: The age range of population studied is from 13 to 85 years old with 243 males and 230 females. Out of the 473 participants, 13.1% adolescent, 37.6% young adulthood, 36.4% middle adulthood and 12.9% in late adulthood. We observed that the male mean weight was 68.27±12.72kg versus 58.86±12.45kg mean weight in female. The prevalence of drinkers – 3.6% depen-dent drinkers, 22.2% high risk drinkers, 36.2% low risk drinker while the remaining 38.1% are abstainers. Majority of consumers were practicing low-risk drinking pattern which highlighted the need for prevention and harm minimiza-tion programme. Paired sample t-test shows that the decrease in AUDIT three months after intervention is statistically significant. Conclusion: This study conducted in KK suggests that screening coupled with brief intervention can help reduce alcohol misuse and risky drinking and should be practiced in all primary healthcare facilities.
Introduction: This study aimed to investigate the relationships between parental effort to control the child’s food intake among primary school children with parents’ ‘control’, ‘restriction’ and ‘reward’ on limiting children to eat unhealthy foods. Methods: Data were collected among 485 primary school children and their parents. Questionnaire for Obesity survey among primary school children was used to document on the child’s daily food intake for one week. Results: All predictor variables are significant at the p