Introduction: A handful of medical schools have implemented the Islamic input in medical program into their medical curricula. However we are facing a setback as there is no validated standard assessment tool to measure the effectiveness of this academic input for undergraduate medical programme. Therefore the objective of this study is to design a scale that is able to gauge the impact of the Islamic input among medical undergraduates. Materials and Methods: The construction of a new scale is based on the 5 stages of standard questionnaire design. To validate the newly designed scale, it was administered to all the medical students who granted their consent. Results: A total of 520 students from all academic years of a medical school were enrolled in the validation stage. Bartlet’s KMO value is 0.9. From 46 items, 67% had good factor loading (>0.4). Cronbach’s alpha values of 0.78, 0.85 and 0.13 were obtained for Attitude, Practice and Knowledge domains respectively. We identified the 3 domains by using exploratory factor analysis. Conclusion: The scale has good psychometric values for both reliability and validity.
Chylothorax is suspected when milky white turbid fluid is obtained from thoracocentesis. Conservative management usually involves intercostal tube drainage, dietary restriction, and total parenteral nutrition. Surgery is indicated when conservative management fails. We describe a young woman with idiopathic chylothorax who failed conservative therapy but refused surgery. We instilled intrapleural streptokinase, which improved her condition.
Objectives
To evaluate the association between ultrasound assessment of gallbladder wall thickness (GBWT) among severe dengue patients and dengue patients with warning signs to their clinical outcomes.
Methods
A prospective, cross-sectional study involving adult dengue patients presented to our emergency department between March until September 2018. The patients were classified based on WHO classification. A gallbladder wall scan was performed on all patients.
Results
A total of 44 patients were enrolled into the study; majority of the patients with GBWT had severe dengue, significantly more than the dengue patients with warning signs (90.5% sensitivity; 69.6% specificity). The sensitivity of GBWT in determining admission to critical care areas or general ward was 100% with a specificity of 62.1%. Our analysis showed that the two variables significant in determining the severity of dengue were age (p = 0.045) and GBWT (p < 0.001). Both factors together gave 81.0% sensitivity and 78.3% specificity in predicting patients for severe dengue. The receiver operator characteristic curve revealed that using variable GBWT status can discriminate 87.1% (95%CI 66.3, 93.7%) of having severe dengue or dengue with warning signs.
Conclusion
The finding of GBWT when consolidated with other clinical parameters may assist clinicians to perform risk stratification in the emergency department and become another adjunct to the assessment of severe dengue.
We report a case of a 34‐year‐old lady with past history of asthma and pulmonary tuberculosis, who presented 5 weeks pregnant with acute dyspnea. Her chest X‐ray showed left‐sided complete lung collapse and concomitant right‐sided pneumothorax. The pneumothorax was initially managed conservatively with a chest tube but due to its persistence despite suction, was subsequently changed to a PneumostatTM, with which she was later discharged. She had a normal echocardiography (ejection fraction [EF] 67%) at 5 weeks of gestation but developed pulmonary hypertension (EF 55%, pulmonary arterial pressure 40.7 mmHg) as the pregnancy progressed. She delivered a healthy baby at 35 weeks via elective lower section caesarean section with spinal anesthesia. We followed her up postnatally and noted the presence of left‐sided pulmonary embolism, hypoplastic left lung, and left pulmonary artery. The management of this complex case involved a multidisciplinary effort between general medical, respiratory, obstetric, and cardiothoracic teams.
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