Borneo Journal of Medical Sciences (BJMS)

Impact of Bilateral and Unilateral Post-Activation Potentiation on Immediate Cycling Performance

Stephanie Chok — 2024-11-25

Post Activation Potentiation (PAP) warm-up strategies are gaining attention for their potential to enhance athletic performance. This study aims to compare the effects of unilateral PAP (UPAP) and bilateral PAP (BPAP) on cycling performance. Using a randomised crossover experimental design, 50 trained recreational male cyclists, aged 18 to 40, participated. Each cyclist’s regimen included 4 sets of 5 Repetition Maximum (RM) for back squats (BPAP) and rear leg elevated split squats (UPAP). The exercises were performed on separate occasions, followed by a Power Profile Test developed by the World Cycling Centre (WCC-PTT). Results showed that 85% of 1RM BPAP significantly improved 30-second average power, relative average power, average cadence, and average torque. Conversely, 42.5% 1RM UPAP notably enhanced peak power, peak cadence, and peak torque, with significant improvements in 6-second average power, relative average power, average cadence, and average torque. When the intensity of UPAP was reduced to 42.5%, significant improvements in average power output and average cadence were observed in the 4-minute test. This study highlights the importance of tailoring PAP type and intensity to the specific demands of the sport or event to enhance performance by effectively targeting relevant muscle groups.

Short-term Outcomes of a Dedicated Pelvic Exenteration Unit in a Tertiary Hospital in Malaysia

Khairul Hazim Hamdan — 2024-11-14

Background : Pelvic exenteration offers potentially curative resection for locally advanced pelvic malignancy. A dedicated unit performing this complex surgery is recommended to achieve optimal outcomes.
Objectives : The aim of this paper is to show that pelvic exenterations can be performed with acceptable oncological and safe perioperative results in an appropriately resourced specialist centre. Methods : Patients undergoing pelvic exenteration in the Colorectal Unit, Hospital Kuala Lumpur between January 2017 and January 2024 were included. Patients operated in the initial setup period of the unit (January 2017 – July 2020) were compared to the second half (August 2020 – January 2024) with univariate analysis. Results : A total of 30 patients were included, with a significant increase in the unit caseload over the study period (n = 11 versus n = 19). There was an increased use of neoadjuvant therapy and an increase in stage of disease at presentation (p = 0.014) in the second half of the study period. More complex procedures were performed in the latter period, involving both bony and pelvic side wall resections. There was no difference in complication severity (Clavien Dindo) (p = 0.257) and R0 resection was achieved in 76.7% of operated cases. Conclusion : The development of a dedicated pelvic exenteration unit, leads to an increase in patient volume and an increase in the complexity of the procedures performed, without compromising short term outcomes and safety.

A Scoping Review: Topical Treatment of Infectious Skin Diseases with Remedial Plant Oils

Nurul Iman Mohd Daud — 2024-11-25

Skin infections are common ailments that affect people of all ages. One of the approaches to treating these infections is the topical application of plant oils. However, research on the therapeutic use of plant oils as remedies for skin infections remains limited. This scoping review aims to identify research gaps by assessing the types of skin infections that respond effectively to plant oil treatments. The review is conducted in three phases: the planning, conducting and analysing phases. During the planning phase, an outline of the review is developed. The conducting phase utilises the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISM) method to extract relevant data. The analysing phase involves summarising and reporting the findings. This review focuses on the usage of two classes of plant oils: essential and cooking oils, in treating bacterial, fungal, viral, and parasitic infections by evaluating their efficacies, formulations, and dosages. It also explores the methodologies, application frequencies, treatment durations, and trial limitations. Overall, tea tree oil emerged as the most commonly used treatment, with other oils showing beneficial outcomes despite variations in methodologies. Applying standardised treatment protocols, optimum sample sizes and control groups may improve the result of these studies.

Impact of COVID-19 Towards Antibiotic Consumption in a Major Specialist Hospital: A Non-COVID-19 Hospital Perspective

Laura Soon — 2024-12-02

The Coronavirus disease 2019 (COVID-19) pandemic heavily affected healthcare services and medication supply. Literatures showed that the consumption of antibiotics was significantly increased during the pandemic especially in COVID-19 hospitals, however, little is known about the collateral impact of the pandemic in non-COVID-19 healthcare settings, such as Hospital Queen Elizabeth II (HQEII) based in Malaysia. This study aimed to compare the prevalence of antibiotic consumption before (2018 & 2019) and during (2020 & 2021) the pandemic, and to explore its impact on antibiotic-acquired cost and bacterial resistance. This is a descriptive observational study where the antibiotic consumption from 1st January 2018 to 31st December 2021 in HQEII was reviewed. The antibiotics selected were Meropenem, Vancomycin, Piperacillin-tazobactam, Ceftazidime and Ceftriaxone. The antibiotic consumption, antibiotic-acquired cost and cases of multidrug resistant organism (MRO) before (2018 & 2019) and during (2020 & 2021) the COVID-19 pandemic were compared, with combined 2 years data for comparison. The overall consumption of the selected antibiotics significantly increased by 45.2% (34.8 vs 50.5, p<0.001) during the COVID-19 pandemic. Intensive care unit had the highest increase in antibiotic consumption (+114.3%, p<0.001). There was a raising trend for the use of Vancomycin, Meropenem, Ceftazidime and Piperacillin-Tazobactam (p<0.005). All these contributed to a significant increase in antibiotic-acquired cost by 64.4% during the COVID-19 pandemic (RM909,898.80 vs RM1,486,791.20, p<0.001). Notably, cases of multidrug resistant organisms also increased, especially MRO Acinetobacter (+197%) and Carbapenem-resistant Enterobacterales (+92%). High antibiotic consumption, antibiotic-acquired cost and MRO cases were observed in non-COVID-19 healthcare setting during the pandemic, but the factors contributing to the surge were not explored in this study.

Subcutaneous Mycoses on The Face Of A Child: A Case Report

Abdul Hadi Said — 2024-11-14

Skin infections is a common presentation at primary healthcare clinics. It may be caused by a variety of pathogens, including viruses, bacteria, fungi, or parasites. The most common skin infections are caused by bacteria, namely Staphylococcus aureus and Group A beta-haemolytic streptococci. Fungal infections, particularly subcutaneous mycoses, may exhibit similar clinical features as bacterial infections. In this case report, we highlight the importance of considering subcutaneous mycoses as a differential diagnosis for patients presented with skin infections, especially if the condition did not improve with antibiotic. This case report also emphasised the importance of considering the potential side effects of systemic antifungal medications before initiating the treatment in children. Accurate diagnosis through culture testing is essential to guide the treatment, rather than relying solely on empirical treatment based on clinical symptoms.

Tropical Primary Pyomyositis of The Right Calf Muscle: A Rare and Unexpected Complication of Jump Squat Exercise

Rashidi Ahmad — 2024-11-14

Diagnosing pyomyositis in its initial or invasive stages can pose a challenge due to its vague initial symptoms, which may mimic other conditions such as muscle strain, localized myositis, hematoma, deep vein thrombosis, cellulitis, or thrombophlebitis. A high index of suspicion for possible pyomyositis necessitates confirmation through radiographic imaging. A delayed diagnosis directly correlates with the time taken to commence treatment, thereby increasing the risk of patient morbidity and mortality. We present a case of a diabetic male who experienced bilateral calf muscle pain and right calf swelling after participating in jumping squat exercises, eventually developing right calf myositis and abscesses over a two-week period, which were initially overlooked by several general practitioners. This case underscores the crucial role of radiographic imaging in confirming the diagnosis, whether in the Emergency Department or any primary care setting. Prompt diagnosis and intervention, as demonstrated here, are imperative for minimizing the risks associated with this potentially severe disease. Knowledge of this condition and its diagnostic methods is highly advantageous for emergency physicians, primary care providers, and family physicians.

A Case of Disseminated Tuberculosis with Atypical Presentation In An Older Person

Tyng Sam Ng — 2024-11-14

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. It is a significant health concern, with millions of new cases and deaths reported each year. Disseminated tuberculosis (dTB) is a serious condition which can affect various organs and tissues, leading to widespread symptoms and complications. The diagnosis of dTB can be challenging due to its atypical presentations. We present a case of dTB in a robust older person who presented with musculoskeletal pain, weight loss, and loss of appetite. Initially, he was treated for age-related spine disease, and pain management was provided. However, his subsequent visit raised suspicion of TB, prompting further work up. The diagnosis was revised to dTB, and anti-TB treatment was initiated. The near miss or delay in diagnosis and treatment may have played a role in dissemination of disease, increased frailty and reduction of function in this patient. Healthcare workers must maintain a high index of suspicion and remain vigilant for TB as starting early treatment will prevent dissemination in the patient, reduce risk to the public and improve outcomes.