Universal Screening For Gestational Diabetes Mellitus In Antenatal Mothers Improves Antenatal Management And Outcomes – Single Centre Experience

@#This study examined the impact of universal screening in diagnosing and managing gestational diabetes (GDM) amongst antenatal mother and associated neonatal outcomes. It is a single-centre, retrospective study on routinely collected data of antenatal women in Health Clinic Seremban over one year in 2018. All women diagnosed with GDM, who were not known sufferers of type 1 or type 2 diabetes were included in this study. Participants were stratified according to risk factors for GDM to compare the performance of a selective high-risk screening approach to that of universal screening for detecting GDM. Subjects were categorized as high-risk for GDM based on the guidelines recommended by the Malaysian Clinical Practice guidelines. It was found that through universal screening, 246 antenatal mothers were tested positive for GDM out of the 987 of these mothers without prior diabetes, giving a prevalence of 24.9%. If selective screening using traditional risk factors had been employed, 54 (22%) of the antenatal mothers diagnosed with GDM would have been missed. It was established that risk factors for GDM included advancing age, other ethnicities (patients that are not of Malay, Chinese nor Indian ethnicities), obesity, history of abortion or GDM and family history of diabetes mellitus. Neonatal outcomes of those with GDM as compared to those without were similar. This study highlights that universal screening improved GDM detection rates amongst antenatal mothers. The increased detection helped facilitate an earlier intervention which may have contributed to better antenatal management and outcomes for neonates and their mothers.

Voyeuristic Disorder and Internet Pornography Addiction: A Case Report

@#With the availability of the Internet, pornographic materials are readily accessible. Pornographic materials may have a link to addiction and other deviant sexual behaviour. In this case report, we highlighted a link between voyeuristic disorder and internet sex addiction. Mr. SK is a 22-year-old single gentleman who was referred for psychiatric assessment due to voyeuristic acts. He had been watching pornographic materials since 16 years old and became addicted to it.

The Development of Profession of Rehabilitation Counseling in the United States / 中国康复理论与实践

@#This article describes the development of the rehabilitation counseling profession in the United States. Early roles as a government agent providing simple vocational advice and guidance to individuals with physical injuries grew into a complex professional role. That role now demands knowledge of occupations, disability issues, psychological testing and evaluation, legal issues related to employment as well as personal counseling skills. Specialized university educational programs at the master's degree level now prepare individuals for this profession. While early employment tended to be exclusively with public and government agencies, current rehabilitation counselors work in a variety of public, community, and private rehabilitation agencies as well as in educational and school settings. While a uniquely American profession in development, the skills and training of this profession may have application to other cultures as well.

A case report of endovascular stenting in Salmonella mycotic aneurysm: a successful procedure in an immunocompromised patient

<p><b>INTRODUCTION</b>Mycotic aneurysms are associated with high mortality rates and are managed in the local setting with extra-anatomical bypass followed by ligation, exclusion and debridement of the aneurysm. This is the first case of successful endovascular stenting in an immunocompromised patient with Salmonella mycotic aneurysm.</p><p><b>CLINICAL PICTURE</b>A middle-aged man who was HIV positive had Salmonella septicaemia. He developed abdominal pain 5 days after admission and a computed tomography (CT) scan of the abdomen revealed infrarenal aortitis. He developed a mycotic aneurysm 3 weeks later.</p><p><b>TREATMENT</b>He opted for endovascular stenting and after prolonged antibiotic therapy and negative blood cultures, he underwent the procedure using a Talent stent, with an iliac extension.</p><p><b>OUTCOME</b>He was discharged 1 week after stenting and maintained on oral bactrim based on sensitivity. At 1-year follow-up, he remains well symptomatically and CT scan showed no endoleak or collection.</p><p><b>CONCLUSION</b>Endovascular stenting, though a fairly new procedure, can be successfully deployed even in a mycotic aneurysm in the right setting.</p>

Prevalence of overweight among secondary school students in Klang district, Selangor

Overweight and obesity place children and adolescents at increased risk of significant health problems, both during their early life and adult life. A crosssectional study was carried out to determine the prevalence of overweight among secondary school students aged 13-17 years in the Klang district and to determine the association between overweight and age, sex, ethnicity, religion and blood pressure. Random cluster proportionate to size sampling technique was used to select the respondents. Weight was recorded using TANITA model HD-309 and height was measured using SECA Body meter Model 208. A mercury sphygmomanometer was used to measure blood pressure manually. Statistical analysis was carried out using SPSS version 13. Out of the 3,333 respondents, 11.4% were found to be at risk of overweight and 8.2% were overweight. The prevalence of overweight was significantly higher in the males (10.6%) as compared to females (6.0%). Prevalence of overweight was highest in Malays (10.7%) followed by the Indians (7.1%) and the Chinese (5.9%). Prevalence of ‘risk of overweight’ was highest in the Indians (13.7%) followed by Chinese (12.0%) and Malays (9.8%). There was a moderate direct significant relationship between overweight and systolic blood pressure (r=0.5, r2=0.25, p<0.001) and also diastolic blood pressure (r=0.42, r2=0.18, p<0.001). The relationship between BMI and overweight was very weak (r=0.11, r2=0.01 and df=3331, p<0.001). In conclusion the prevalence of overweight among the secondary school students is high and there is a need for a comprehensive integrated population-based intervention program.