ABSTRACT
@# Since 1978, Rohingya refugees have fled from their native nation, Myanmar to escape ethnic prosecution. They comprise of the Muslim minority ethnic group originating from the Rakhine state in Myanmar. In many host countries, they may have difficulty to access health care services. The Islamic Association of Malaysia (IMAM) Response and Relief Team (IMARET) have taken many initiatives to provide healthcare services to the refugees through their volunteer-led mobile clinics. Therefore, this study aims to evaluate the utilisation of drugs among type 2 diabetes mellitus (T2DM) patients visiting this clinic. Methods: This was a cross-sectional study among Rohingya refugees with T2DM that visited the IMARET mobile clinics from August until November 2017. Convenient sampling method was used. Data were collected through patient’s interview, review of the patient’s prescriptions and their HbA1c readings. Results: A total of 29 T2DM patients were included in this study. The majority were female (75.9%) and aged below 65 years old (75.9%). The most commonly prescribed anti-diabetic agent was metformin (72.2%), followed by glibenclamide (22.2%) and gliclazide (5.6%). Metformin as a monotherapy (31%) was the most frequent treatment prescribed. More patients had controlled T2DM (62.1%) compared to those with uncontrolled DM. We found 90.9% of patients who were treated according to the recommended DM guidelines achieved a good blood glucose control (p=0.02). Conclusion: In Rohingya refugees having T2DM who were treated in the IMARET mobile clinic, the percentage having good control DM status is higher in those whose treatment regimen adheres to the clinical practice guidelines. Drug utilisation evaluation; Diabetic patients; Diabetes mellitus; Rohingya refugees; Mobile clinic
ABSTRACT
Malassezia furfur is alipophilic yeast that causes skin disease. To evaluate the level of IL-10, IFN-alpha and IL-12P70 in co-incubation of M. furfur grown on different forms of natural oils with PBMCs of healthy individuals. PBMCs were obtained from blood samples of normal volunteers. M. furfur was cultured in different culture media containing almond oil, fish oil, walnut oil, full-fat milk, and a fat-free medium; and the yeasts grown were harvested and used for co-incubation with PBMCs in vitro. The IFN-alpha, IL-10, and IL-12P70 levels were measured at different time intervals using ELISA methods. Generally, IFN-alpha and IL-10 levels in the coincubation of yeasts with walnut oil group [WOG] and fish oil group [FOG] were higher than those in the almond oil group [AOG] and full-fat milk group [FFMG]. Although the IL-12P70 was higher in groups such as AOG, FOG, and WOG; the increase was not statistically significant. The results demonstrated that the type of fat used by M. furfur in the culture media can influence the immune response and increases IFN-alpha and IL-10 levels in an early time point of the culture system
ABSTRACT
Bleeding as the result of a leech in the male urethra is very rare. We describe a 13-year-old boy who had a leech in his urethra. In the emergency department he persistently squeezed his penis in an attempt to prevent the leech from going deeper into his urethra. Manual removal by forcep failed and cystoscopic removal was recommended. Penile block with lidocaine 1% relieved the pain and enabled him to squeeze his penis harder until the leech was pushed out making forcep removal easier. Post-removal he had hematuria and penile pain for 2 days. A description of his presentation and management, along with a review of the literature is presented.
Subject(s)
Adolescent , Animals , Hematuria/etiology , Humans , Leeches , Male , Urethral Diseases/parasitologyABSTRACT
We describe a 5-year-old girl who had sudden onset difficulty in walking after 3 days of febrile illness. In the emergency department her creatine kinase level was elevated but urine myoglobin was normal. She was diagnosed as having benign acute childhood myositis. Because of poor oral intake and dehydration, she was admitted to the pediatric ward. The next day she had a petechial rash over the antecubital fossa, and dengue IgM back was positive. She was treated conservatively and recovered uneventfully. Despite dengue fever being endemic in Malaysia, this is the first case report of myositis following dengue infection in Malaysia.