Investor Presentaiton

IJMS INTERNATIONAL JOURNAL of MEDICAL STUDENTS MMSS 2015 S62 Abstracts Abstracts Introduction: Reaction time (RT) is the elapsed time between the presentation of a sensory stimulus and the subsequent behavioural response. Physical exercise has been shown to develop or maintain mental & physical fitness and overall health. The objective of this experimental study is to assess the effect of short term exercise on reaction time among MMMC students. Methodology: This is a single-blinded RCT conducted on medical students from Melaka Ma- nipal Medical College (MMMC) over an 8 week period. Using block randomization, 60 participants aged 18-28 were randomized into 2 experimental groups who performed exercise of different intensities, and a control group. Prior to the intervention (exercise), each partici- pant completed a self-administered structured questionnaire. Blood pressure, heart rates, memory, reaction time were measured before and after intervention. Collected data was processed in Microsoft Excel, and analyzed using Epi-info 7 and SPSS. Descriptive statistics and ANOVA were calculated. Results: There was a significant differen- ce of Systolic Blood Pressure and Pulse Rate between intervention groups (p<0.05). Changes in Reaction time, Diastolic BP and Memory were not significant (p>0.05). Participant perception was measured using EFI scoring. Higher Total EFI and subscale scores indicate more positive mood states, while higher Physical Exhaustion scores indi- cate greater physical exhaustion. We found a significant difference in positive engagement and revitalisation (p<0.05), but no significance differences in tranquillity and physical exhaustion, (p>0.05). Conclu- sions: Aerobic exercise of different intensities produces no improve- ments in reaction time. However exercise improves mood. Exercise could help create a more enthusiastic, happy society. Exercise also helps in keeping the body refreshed and energetic, promoting a stress-free environment. 18 Glycemic control among adult patients attending follow up in specialist clinics, University of Malaya Medical Center and the guideline adherence in their management Tan Yin Zhien University of Malaya Introduction: The prevalence of diabetes mellitus has been on the rise in Malaysia. The Clinical Practice Guideline (CPG) for manage- ment of diabetes mellitus was updated to the latest version in 2009, but the guideline adherence in managing diabetes mellitus remained unknown. Objectives: To look into the co-morbidities, diabetic medi- cations, glucose control, pill burden of the patients living with diabe- tes mellitus, the percentage of guideline adherence in terms of blood pressure control and prescription of statin among diabetic patients. Methods: A cross-sectional study was conducted at the medical cli- nics of University of Malaya Medical Center, randomly recruiting 456 diabetic patients who has follow-up in the clinics in November and December 2014. Patients' demographic, co-morbidities and clinical information were gathered mainly via interview, while patients' medication and blood investigation results were retrieved from the medical records of the patients. Results: Dyslipidemia and hyperten- sion are the common comorbidities associated with diabetes me- llitus (80.3% 77.6%). The drug combination with most number of patient is biguanide with insulin (21.7%). Glucose control among the respondents are poor generally, with only 23.5% and 27.6% of the patients achieving target HbA1c and fasting plasma glucose levels respectively. Conducting a logistic regression using poorly controlled HbA1c as dependent variable, variables that significantly contribu- te to the model are employment, triglyceride level, fasting plasma glucose and type of anti-diabetic treatment (p<0.05). Blood pressure control is poor among the diabetics. Guideline adherence is good in the aspect of prescription of angiotensin converting enzyme inhibitor (ACEI), angiotensinreceptor blocker (ARB) and statins for hypertensi- ve and dyslipidemia patients among the diabetic respondents. 46.3% of the patients are taking 6 to 11 pills daily (including aspirin and medication for diabetes, hypertension, dyslipidemia), with medica- tion for other conditions not included. Conclusion: The glycemic and blood pressure control among the patients being followed-up in the medical clinics in UMMC remained poor. The guideline adherence in terms of prescription of ACEIS, ARBS and statins are good generally. More recommendations from the guidelines should be studied to obtain an overall picture of guideline adherence in managing dia- betes mellitus. 19 Perioperative Management of Patients with Cardiac Implan- table Electronic Devices Tharsini Sarvanandan University of Manchester Introduction: Worldwide, several million people have received a car- diac implantable electronic device (CIED) as treatment for their arr- hythmias. Although the introduction of these devices has completely transformed the treatment of patients who have cardiac conduction problems, it has made the management of these patients periope- ratively more complex due to the presence of the device itself. Aim: This review aims to look at the basics of CIEDS, specifically, the va- rious types and their function as well as current opinion and guidan- ce on managing patients with these devices perioperatively. It also takes into consideration the potential complications that may arise and any interference these devices may be susceptible to in this cri- tical period. Methods: A search was conducted through electronic da- tabases including PubMed, EMBASE and Ovid. Keywords used in this search were 'pacemakers' OR 'implantable cardioverter-defibrillator' OR 'ICD' AND 'anaesthesia' OR 'perioperative'. The list of the search results was reviewed to determine the relevance to the topic at hand by screening the title and abstract of the papers. Results: In order to increase the probability of a good outcome, a thorough preoperative assessment as well as vigilant monitoring throughout this period is vital. Appropriate measures to ensure patient safety including repro- gramming the device should be considered. Conclusion: The preope- rative assessment is an opportunity to elicit information from the pa- tient regarding their overall health and the function of their device so that the right preparations can be made if intraoperative problems are anticipated. During surgery, continuous monitoring is essential and equipment for resuscitation must always be readily available. Postoperatively, device function should be evaluated again. 20 Factors Associated with Differences in Haemoglobin Levels in Community-Dwelling Older Individuals in the Klang Valley Yew SY', Bee PC², Tan MP3,4 1 Fourth Year Medical Student, 2 Division of Haematology, 3 Division of Geriatric Medicine, 4 Ageing and Age-Associated Disorders Research Group, De- partment of Medicine, Faculty of Medicine, University of Malaya Introduction: Anaemia is a significant independent contributor to morbidity, mortality and frailty in elderly patients, and can lead to cardiovascular and neurological events. It has a great impact on the quality of life. The objective of the study was to determine the fac- tors associated with differences in haemoglobin level among the community-dwelling elderly in Klang Valley. Methods: Participants in this cross-sectional study were recruited from community-dwe- lling elderly (65 years and above) in Klang Valley during health awareness events. Anemia was defined according to World Health Organization (WHO) criteria as a hemoglobin (Hb) level of less than 13.0g/dL in men, and less than 12.0g/dL in women. Results: A total of 137 sampled residents met the criteria for data completeness and were retained for analysis. Mean age was 71.6 + 5.9 years. Using WHO criteria, 9.5% of the participants were anaemic. Factors asso- ciated with differences in haemoglobin levels statistically (p<0.05) were educational level of primary level or less (p=0.003) and age > 70 years (p=0.007). Hemoglobin level correlated significantly with weight(r=0.406, p<0.001), height(r=0.335, p<0.001) and BMI(r=0.242, p=0.006), but negatively with age(r=-0.231, p=0.007). Conclusion: Lower educational level, age, lower body weight and BMI and lower height are associated with lower haemoglobin levels among commu- nity dwelling older residents in the Klang Valley. An understanding of risk factors associated with anaemia will help direct efforts to reduce the burden of anaemia in our population. Abstracts of 11th Warsaw Internation Medical Congress (WIMC) Dentistry Case Report 01 Elongated Styloid Process Syndrome Eagle's Syndrome - Presentation Of Two Cases Jacek Michał Nowak, Marcin Piotr Szerszeń Medical University of Warsaw / Department of Oral Surgery Background: Eagle syndrome or syndrome of prolonged styloid process of the temporal bone is a rare syndrome, which cause is an extended styloid process and often concomitant an ossification stylohyoid ligaments. Patient typically reports to a doctor because of sudden severe pain in his ear, throat, floor of mouth the oral side of the neck and jaw angle around the lodge tonsil. This pain occurs when you open your mouth, turn the head or swallow. Addi- tional symptoms which are coexisting may be drooling, dysphagia, odynophagia, trismus, body sensation something in the throat. Pain symptoms occur suddenly and last from a few seconds to several minutes. Case: 56 year old man being treated for a pain and swelling on the left side of the face on heighti second and third molar. The patient is treated with immunosuppressants because of a kidney transplant. In a clinical study inflammation around the tooth 37, which was removed in the pocket of antibiotics and inflammation of the tooth 38, which had to be removed on the next visit. Despite per- formed surgeries, the patient is complaining of a pain and a trismus. The study revealed CBCT exacerbation of inflammation left temporo- mandibular joint and extended the styloid process syndrome. A 65 year woman before the transplant. In a clinical study need to revise the endodontic treatment of teeth 31, 34, or their extraction. In the photo OPG noted considerable length styloid process extending on the right to the angle of the mandible, and the left side to the middle branch of the mandible. After the additional interview, the patient is given signs in the front triangle of the neck. Conclusions: Eagle syndrome is a rare syndrome that poses diagnostic problems due to the very characteristic symptoms, which include sore throat, odynophagia, headaches, foreign body sensation in the throat. In order to make the diagnosis should be performed CT, which shows elongated styloid process and is rise in the diagnosis. 02 Erythema Exsudativum Multiforme - Methods of Treatment In The Dental Office Based On The Description of Patient Admitted To The Department of Periodontology And Oral Mucosa Disease Anna Haładyj Department of Periodontology and Oral Mucosa Disease, Medical University of Warsaw Background: Erythema multiforme is an acute disease of the skin and mucous membranes, recurrent in 25% of cases, mostly obser- ved in men. Characterized by erythematous-edematous changes, forming concentric figures, blisters and bloody ulcerations on lips. The disease is caused mainly by infectious agents, states of altered immune reactivity and certain medications. Case: 23-year-old patient was referred by an internist to the Department of Periodontology and Oral Mucosa Disease because of the presence of painful ulcers on angles of the mouth, buccal mucosa, upper and lower lips and erosions on the hard palate. He was already taking Heviran due to changes on the skin on the back of the hand, Telfast and Groprinosin prescribed by the internist. In dental office, compresses with 0,1% Laticort were applied to the inflammatory changed places, patient was instructed to take vitamin C, calcium and to continue the an- tihistamine and antiviral therapy. On subsequent visits, wraps with 0.25% Corhydron were continued, regression of pain and healing of the changes were observed, which eventually disappeared after 3 weeks. The patient came back to the Department after 5 months due to recurrence of the disease. Erosions showed again on the mucosa of lips, cheeks and palate. The patient has already received Telfast. Calcium, Tantum Verde and vitamin C were prescribed. Next three visits showed healing of changes on the mucosa, compresses with 0.25% Corhydron were sustained. The patient did not showed up again. Conclusions: In the dental office, in order to reduce the pain in the patient with erythema multiforme, corticosteroid solutions are being used to spray the oral mucosa. Systemic treatment is carried out with antihistamines, antiviral and sealing vascular endothelium drugs. Dentists should pay attention to the patient's medical history and try to determine a possible causative factor which elimination is the basis of the therapy of erythematous-edematous changes. 03 Pharmacological - Prostethic Treatment Of A Patient Pre- senting Dentureinduced Stomatitis Complicated By Fungal Infection Case Report Magdalena Walczak, Anna Walawska, Kamila Wróbel-Bednarz Medical University of Warsaw Background: Denture induced stomatitis (DIS) complicated by fungal infections is a common problem observed in patients with complete prosthetic restorations. This is usually related to many factors, in- cluding patients' physical conditions as well as special conditions prevailing in the oral cavity under the upper denture base. Specific microclimate often promotes fungal infections, especially Candida albicans infection can be observed. Patients then complain about a number of ailments, such as: pain, burning sensation, bleeding and serious problems with eating and talking. Case: This paper presents a case of treatment of the patient diagnosed with DISComplicated by fungal infections. The problem was indirectly caused by self-repair of the damaged upper complete denture. As a result of prosthetic and pharmacologic treatment, a significant improvement of patient's clinical condition was observed. Conclusions: Proper oral hygiene instructions and immediate implementation of suitabletreatment are essential and lead to recuperation from fungal infections. Patient's motivation, meticulous oral hygiene routine and regular follow-up visits are extremely important for patients with complete prosthetic dentures. These contribute to increase the time-of-life of this type of restorations in the oral cavity as well as reduce the risk of further complications including denture induced stomatitis. 04 Asymptomatic Sialolithiasis In The Duct of Submandibular Gland Case Report Michał Oszwałdowski, dr Paweł Nieckula, dr Bartłomiej Iwańczyk, dr Igor Kresa Students' Scientific Group, Department of Dental Surgery, Medical University of Warsaw Background: The paired submandibular glands are major salivary glands and produce 75% of saliva. Properties and components de- fine proper functions of saliva. However, under some circumstan- ces nonorganic part of it may form a salivary calculus. Presence of concretion sialolithiasis is the most common salivary gland disease, which occurs typically between the fourth and sixth decade of life. The state is characterized by the obstruction of a salivary gland or its excretory duct. The usual symptoms are pain and swe- lling of the affected gland, but the patient's case proves that such condition may remain asymptomatic, despite the fact that the size of salivary calculus in his submandibular gland duct was found to be substantial. Case: A 23-year-old male was referred to the Dental Surgery Department of the Medical University of Warsaw with the complaint of painless, egzofitic formation localized on the floor of the mouth, noticed by him few days before the appointment. Clinical examination revealed solid and yellowish mass under mucosa in the left Wharton's duct indicating sialolithiasis. Calculus was clinically filling the entire lumen of the duct. There were no obvious sings of INTERNATIONAL JOURNAL of MEDICAL STUDENTS www.ijms.info • 2015 Vol 3 Suppl 1 www.ijms.info . 2015 Vol 3 Suppl 1 INTERNATIONAL JOURNAL of MEDICAL STUDENTS 11th WIMC 563