MASH Journal Volume 8 Issue I

March 2023
Tuberculoma In A Healthcare Worker
Teo Kye Vonn, Nur Adlina, Ng Tyng Sam

Tuberculosis (TB) is an endemic and a public health concern around the world. It commonly affects the lungs, however it can affect other organs, which known as extrapulmonary tuberculosis. Extrapulmonary TB occurs in around 10-15% of all TB cases. Central nervous system (CNS) TB is one of the severe types of extrapulmonary TB, accounts for around 1% of TB cases. It resulted from Mycobacterium tuberculosis (MTB) spread via hematogenous to intracranial. Tuberculoma is around 0.2% of all biopsies brain masses.

Keningau Weave Technique: A modification Of The Japanese “Himawari” Method For Comminuted Patella Fixation
Eyrique G, Jeremy SV, Vickneshan S, Amir R, Looi C

Severely comminuted patella fractures deemed unsalvageable have traditionally been treated with patellectomies. This procedure significantly reduces the mechanical advantage the patella provides to the quadriceps for knee extension resulting in significant morbidity. The ‘Himawari Method’ developed in Japan has significantly reduced the need to resort to patellectomies. However, this procedure requires the use of expensive locking sleeves to be successful. The modified technique illustrated here excluded the need for the locking sleeves by weaving cerclage wires around multiple longitudinal k-wires creating an anterior cage over the patella. With the addition of a tension relieving wire, the efficacy of the modified procedure as the patient achieved fracture union with full range of motion at 12 weeks can be demonstrated. Outcome evaluated utilizing the patellar-femoral instability scorings, Favourable Kujala patellar instability scores & Oxford knee score were noted a year post-intervention.

A Brief Review of the Evolutionary Thought and Etiology of the Stomach Disorders with Prevention
Ashraful Kabir

The stomach of animals plays a significant role throughout life. After taking food, the nutrients of those foods maintain all biological processes. The stomach is a reservoir for storing food for several hours. If digestion within the stomach hampers, the entire body will undergo many ailments. Evolutionary changes in the stomach of various animals (herbivores, carnivores, and omnivores) to understand the quality or nature of the stomach based on their food. Based on some articles, oral communication, and an effective questionnaire proved that in a northern region of Bangladesh (Saidpur town under Nilphamari District), out of 60 families, 85% of family members were affected by acidity problems where 37% of college students (17-19 years) due to their excess taking of oily and spicy foods. On the other hand, their regular food intake showed 80% acidic, 7.5% neutral, and 12.5% alkaline food.

A Review of the Genetic Link Between Overweight and Extreme Obesity
Ashraful Kabir

In the present context of the world, obesity is increasing and creating life-threatening diseases in the human body. Everybody whether they are children or adults needs to be more conscious of this issue. Obesity comes from being overweight is nothing but the imbalance of energy within the body. Lots of published articles on the internet prove that obesity either genetic or acquired possible to overcome through diet and exercise according to the guidelines of such experts. Since morbid obesity (obese III) is rare in the world and in few cases, they need to attach surgery. When we take improper food in our usual daily foods, our bodily metabolic functions could be hampered, and finally first overweight then obesity persists. Nutrients of healthy food and physical activities those will burn extra calories are a must for maintaining a healthy life.

Does Peer Pressure and Time Management Play a Role in Academic Stress Among Medical Students?
Lee Yun Shuang, Muhammad Azhar bin Suffian, Kenley Ong Khang Yee, Yogarooban a/l Sreethar, Khine Lynn Phyu, Mila Nu Nu Htay, Soe Moe, Htoo Htoo Kyaw Soe

Academic stress refers to the physical and mental responses of students to academic challenges that are beyond their ability to cope. It can result in significant stress levels and anxiety, especially during exams and other assessments. A study was conducted on undergraduate medical students at Manipal University College Malaysia to investigate the relationship between peer pressure, time management, and academic stress. A total of 130 responses were collected via questionnaires distributed through social media and the data was analysed using Epi Info software. The results showed medical students experienced slightly higher levels of academic stress due to factors such as study pressure, workload, worrying about grades, and self-expectation. However, they experienced slightly lower levels of academic stress due to despondency. Our study also revealed a significant association between peer pressure and academic stress caused by despondency but no significant difference between time management and academic stress. Among the demographic variables, family income is found to be significantly associated with academic stress due to self-expectation and worrying about grades. In conclusion, medical students experienced moderate level of academic stress across all sources of stress. Academic stress among medical students can be caused by factors such as peer pressure and poor time management skills. Effective time managementabilities can aid students in managing their academic responsibilities and decreasing academic stress.

Correlation Between Health Beliefs And Lifestyle Among Medical Students In Malaysia: A Cross-Sectional Study
Bhargavi a/p Visualingam, Chong Guang Wen, Tharani R Mohan, Abhiraami Sathasivam, Hansika Gamage, Htoo Htoo Kyaw Soe, Soe Moe, Khatijah Taharah Mohamed Shah, Mila Nu Nu Htay

In student population, physical activity, dietary pattern, stress, screen time are intertwined to achieve a healthy lifestyle. Therefore, this study aimed to investigate the health beliefs, lifestyle, and dietary habits among the medical student population. This cross-sectional study was conducted by recruiting medical students from a private medical university with purposive sampling. Demographic characteristics, health belief model and lifestyle information were collected by using Google form. Data was analyzed by descriptive statistics, unpaired t-test, one-way ANOVA by using Epi info software (Version 7). A total of 160 students responded to this study.  Age of the respondents was significantly associated with nutritional confidence (P=0.033) and barrier (P=0.032) domains of health belief. While gender was significantly associated with barriers (P=0.041) and behavioral intention to do physical activity (P=0.018). Academic year was found to be associated with susceptibility domain (P=0.013) of health belief. Gender was significantly associated with the physical health and exercise (P<0.001) and psychological health (P=0.012) domains. Age was significantly associated with accident prevention domain (P=0.013). While BMI was significantly associated with physical health and exercises (P=0.001). Academic year was significantly associated with social concern (P=0.028) and sense of purpose (P=0.009) domains. Health beliefs among respondents were correlated with the nutritional and physical activity in their daily lifestyle. Especially having nutritional confidence, knowing the benefits of a healthy diet, behavioral intention to eat healthy food and to do physical activity were significantly correlated with the respondent’s nutrition intake and physical activities. Educational interventions and activities such as talks, trainings related to adopting healthy and active lifestyles could help the medical students in attaining a better lifestyle habit.

Role Of Trauma Whole Body Ct Scan (Selayang Trauma Alert Diagnostic Protocol) In Establishing Direction Of Care For Major Trauma Patients
Fathullah N, Hanim MT, Hanif MN, Gurjeet Singh a/l Harvendhar Singh

Trauma is one of the leading cause of death in the world among young and middle aged people1. Currently in the damage control resuscitation suite of emergency department Selayang Hospital, a CT Selayang Trauma Alert Diagnostic (STAD) protocol was introduced as the gold standard Whole Body CT scan diagnostic work-up to identify hidden injuries, grade injuries and recognize the source of bleed being arterial or venous in origin in major trauma patients. Early and accurate detection of organ injuries, grading the injuries and recognizing its origin in patients presenting with poly trauma to the Emergency Department can change the direction of care from operative to conservative3.

Encounter With An Obstructed Duodeno-Jejunal Flexure Tumour In An Emergency Setting, A Surgeons Dilemma: A Case Report
Chiew Junloong, Sekkapan Thannimalai Sambanthan, Nik Ritza Kosai & Soma Bala Ganapathy

The anatomy of the duodenum is complex, and tumours arising from it are rare even among small bowel tumours, with DJ flexure tumours being very uncommon in the entire gastrointestinal system. They usually present with vague symptoms and is of a unique challenge to surgeons for resection. We present a case report of a 41-year-old gentleman with an obstructed DJ flexure tumour encountered in an emergency setting and its challenges to the operative surgeon.

What Are The Attributes Among Malaysian Medical Students Towards Migrating Abroad? A Cross-Sectional Study
Fathima Nashfa, Ruhashini Chanla, Saranya Saghadevan, Udila Helitha Attygalle, Mila Nu Nu Htay, Soe Moe, Htoo Htoo Kyaw Soe

Brain drain of healthcare professionals is a global pandemic that equally affects Malaysia. Due to multiple ‘push factors’ in Malaysia and multiple ‘pull factors’ in the source country Malaysia is losing qualified doctors at an increasing rate. The study aims to determine the intention and attributes of Malaysian medical students towards migrating abroad. A cross sectional analytical study was carried out from August 2021 to October 2021 involving the medical students of Manipal University College Malaysia (MUCM), Malaysia. Purposeful sampling was applied in the selection of eligible participants. The total number of participants recruited was 168, majority form the clinical batches. Among the participants, 45.24% had a positive intention to migrate abroad, 19.64% did not want to migrate, while 35.41% were undecided. The significant ‘pull factors’ for migration were better quality of health care system and better quality of postgraduate education abroad. The significant ‘push factors’ were peer and family pressure and an unsatisfactory political system at home country. Females were significantly more interested in migrating abroad than males. As brain drain can bring about a negative impact on home country in all spheres, it is vital that the country takes active efforts to minimize the contributory causes and provide incentives that ensure satisfactory work environment for the medical doctors.

EUS-guided Gastrojejunostomy - A Novel Approach
Nicholas Heng Ee Zhing, Tan Sze Hao, Andre Ng Wen Hao and Glenn George Koleth

Endoscopic ultrasound-guided (EUS) gastrointestinal procedures have now been a novel approach to manage complications arising from gastrointestinal malignancy owing to its lower morbidity and mortality rate compared to surgical approach. We present a case of EUS-guided gastrojejunostomy for a patient with advanced pancreatic carcinoma with duodenal obstruction with distant metastasis.