ABSTRACT
@#Food Addiction (FA) is a concept of dependence on substance related to the consumption of palatable foods high in fat, sugar, and salt. This dependence may influence dietary modification advice as dietary modification is an essential component in managing people with diabetes. The objective of this study is to determine the prevalence of FA among people with diabetes. A cross-sectional study was conducted between June and August 2021 at Klinik Primer, Pusat Perubatan Universiti Kebangsaan Malaysia (Cheras, Kuala Lumpur) involving 142 people with diabetes. FA was assessed using the validated Bahasa Melayu version of Yale Food Addiction Scale 2.0. The median age of participants was 58 years (IQR=10), and the majority (88%, n=125) of them were above the age of 45 years. A large majority) had central obesity (90.1%, n=128) and were overweight and obese (91%, n=129). The median duration of diabetes was 10 years (IQR=11) with more than two-thirds (63.4%, n=90) of them having diabetes for more than 5 years. Majority (73.9%, n=105) also had poor glucose control with median HbA1c level of 7.5% (IQR =2). Our study found that the prevalence of FA among people with T2DM was low (2.8%, n=4). This could be because the participants were mostly from the older age group with long standing disease. These two features may have influenced their eating behaviour, becoming more compliant and adapted to diabetic diet advice received over the long duration of the condition. A similar study among young diabetics and those with new onset disease may better reflect FA among this group of people.
ABSTRACT
@#Carcinoma cuniculatum is a rare, slow growing tumour which is commonly mistaken for warts or corn especially when it presents on the sole. Although it rarely metastasizes, it may cause local invasion affecting the underlying tissue and bone. Early identification provides good prognosis as it can be managed with localized resection. We present a case of carcinoma cuniculatum which was misdiagnosed and treated as a common wart for two years until the diagnosis was confirmed by histopathology. By the time of diagnosis, the lesion had involved the underlying bone and patient required amputation. Carcinoma cuniculatum is rare and easily confused with common warts in the early stages hence, it is important to create awareness to identify and differentiate these two conditions.
ABSTRACT
@#This article provides information on allergy testing and serves as a simple guide for physicians who are considering using allergy testing as a step in patient management. Basic principles of allergy testing, indications for testing, and how and when to choose a suitable allergy test are discussed. Allergy testing in general refers to evaluation of either type I or type IV hypersensitivity reactions. The type I (immediate) reaction is evaluated using the skin prick test (in vivo) or serum IgE (in vitro) test methods, while the type IV (delayed) reaction is determined via the skin patch test method. The allergens responsible for a specific reaction can be identified from allergy testing, and this information is useful in administering avoidance measures. Appropriate treatment of allergic reactions along with allergen avoidance ensure a successful treatment outcome and prevent future reactions.
ABSTRACT
@#(T2DM) among the younger age groups is a growing concernworldwide. Thus, assessing the perception of risk andknowledge among those at risk may provide an opportunityfor early intervention, delay or even prevent the onset. Objective: The aim of this study was to determine theperceived risk of developing T2DM and its knowledgeamong the offspring of diabetic patients.Methods: A cross sectional study using a self-administeredquestionnaire was conducted among university studentswhose parents had type 2 diabetes to determine theirperceived risk and knowledge on T2DM. Results: A total of 336 university students participated inthis study and 56.5% of them correctly identified themselvesat risk of developing T2DM. About half of them (52.7%) hadhigher knowledge of T2DM. Male students appeared to havebetter risk perception (p=0.024) compared to females whilethose with mothers affected by T2DM appear to have higherknowledge regarding diabetes (p=0.007). Most of theirinformation regarding T2DM was obtained from the internet(87.5%) and other family members (77.9%).Conclusion: The students whose mothers had T2DM appearto have better knowledge and information regarding T2DMand this was mostly obtained from the internet and familymembers. Awareness regarding diabetes and healthylifestyles advice through primary patients may be beneficialfor their offspring.
ABSTRACT
Background: Obesity in pregnancy causes both maternaland foetal complications hence adequate knowledge ofobesity related pregnancy risks would ensure betteroutcomes. This study aims to determine the knowledge ofobesity related pregnancy risks among pregnant women.Methods: A cross-sectional study was conducted amongpregnant women from four antenatal clinics in Seremban,between February and May 2015. Knowledge on pregnancyrisks was assessed using questionnaire. Women weredefined as having broad knowledge on obesity relatedpregnancy risks if they correctly identified that women whoare very obese, are at higher risk of obesity relatedpregnancy complications and weight loss prior topregnancy is associated with lower risk of obesity relatedpregnancy complications. Descriptive statistics andregression tests were used in the analysis.Results: A total of 315 women participated in this study.Their mean age is 29.3 (SD±4.8) years and majority wereMalay (72.4%). More than half of them were overweight andobese (60.6%). About 63.2% participants had broadknowledge on obesity related pregnancy risk. Education is asignificant predictor of broad knowledge as women withtertiary education had higher odds of having broadknowledge compared to those with only school education(OR 2.1; 95%CI: 1.28 to 3.59).Conclusions: This study found that more than half of theparticipants had knowledge of obesity related pregnancyrisks and that education is a significant predictor forknowledge. Pre-pregnancy care education programmes canhelp identify barriers, introduce simple weight managementstrategies to overcome obesity, to ensure better maternaland foetal outcome
ABSTRACT
Background: Dermatology is a minor module in internal medicine undergraduate curriculum. Limited time is allocated for its teaching. Most graduates are inadequately prepared to diagnose and manage skin diseases. We aimed to identify the core content of a more effective dermatology module. Methods: A modified Delphi method was used to reach a consensus. A questionnaire was developed by a selected panel and sent to 20 dermatologists, family physicians and general practitioners (GPs), respectively. They were asked to rate diseases according to importance. The participants then answered the questionnaire again with results of the first round made available to them. The final module content was identified based on the panel’s collective opinions. Results: Eleven topics had mode and median values of 1 with an agreement level of more than 70%. They were as follows: (1) skin structure and function; (2) infections and infestations; (3) the skin in systemic diseases; (4) dermatology emergencies; (5) drug eruptions; (6) psoriasis; (7) eczema; (8) sexually transmitted infections; (9) leprosy; (10) acne; and (11) clinical skills and diagnostic procedures. A total of 56 diseases were identified as important. Conclusion: Results of this study reflect the importance of understanding the influence of regional factors on common and important skin diseases. These topics may be used to develop a more effective dermatology module for the Malaysian undergraduate medical curriculum.
ABSTRACT
Background: Dermatology in the Malaysian undergraduate medical curriculum is included as a subspecialty subject in Internal Medicine. The dermatology course content for undergraduate varies among the different teaching institutions. A standardized curriculum is required to prepare graduates for clinical dermatological practices in a tropical country and also applicable worldwide. Methods: The Delphi method is used to reach a consensus on the curriculum’s core content. A questionnaire with lists of dermatological conditions was developed by a panel of dermatologists and family physician. A total of 60 participants comprising of 20 dermatologists, 20 family physicians and 20 general practitioners are asked to rate the importance of each dermatological conditions stated in the questionnaire. The same participants then answers the questionnaire again with results of the first round made available to them. The final curriculum content will be identified based on the panel’s collective opinions. Results: We present the results of the first part of the study which is the (questionnaire development). Section 1 of the questionnaire lists 20 topics according to the classification of dermatological diseases and common dermatological diseases. Section 2 expands each classification by listing specific diseases or conditions. There are 4 to 13 diseases identified under each classification. This provides a total of 171 options to be graded by each participant. Section 1 aimed to identify important topics based on the classification and common dermatological diseases. The list of specific diseases aimed to identify the important dermatological conditions or diseases under each classification. Conclusion: A standardized appropriate curriculum in dermatology is required for the Malaysian undergraduate teaching curriculum which is acceptable both locally and internationally. The finding of the study may be used to recommend a standard Malaysian medical undergraduate dermatology curriculum.
ABSTRACT
Myocardial infarction [MI] is known to be common in adults. Interestingly, we report a case of a 15-year-old boy who presented with typical chest pain secondary to myocardial infarct attributable to a combination of familial hyperlipidemia and possible episode of Kawasaki disease in the past. The patient failed treatment and follow-up care, and died 2 years later. Although rare, this case demonstrates that MI should be considered as a diagnosis in adolescents presenting with typical chest pain as early detection, and management is vital for survival
Subject(s)
Humans , Adolescent , Adolescent , Coronary Aneurysm , Multidetector Computed Tomography , AngiographyABSTRACT
A 67-year-old man of Chinese descent presented with a painless nodular lesion that had been present on his right forearm for the previous 3 months. A single, well-defined, dome-shaped, firm nodule with a central keratin plug surrounded by erythema was noted. Keratoacanthoma with secondary bacterial infection was suspected and the patient underwent an excision biopsy. Biopsy of the nodule and immunohistochemical staining supported a diagnosis of nodular malignant melanoma. It should be noted both that nodular malignant melanoma may present with a wide variety of clinical appearances, and that the lack of melanin pigment in nodular malignant melanoma may hinder the diagnosis of this aggressive tumour