Browse publications by year: 2017

  1. Haris H, Looi LJ, Aris AZ, Mokhtar NF, Ayob NAA, Yusoff FM, et al.
    Environ Geochem Health, 2017 Dec;39(6):1259-1271.
    PMID: 28484873 DOI: 10.1007/s10653-017-9971-0
    The aim of the present study was to appraise the levels of heavy metal contamination (Zn and Pb) in sediment of the Langat River (Selangor, Malaysia). Samples were collected randomly from 15 sampling stations located along the Langat River. The parameters measured were pH, redox potential, salinity, electrical conductivity, loss of ignition, cation exchanges capacity (Na, Mg, Ca, K), and metal ions (Zn and Pb). The geo-accumulation index (I geo) and contamination factor (C f) were applied to determine and classify the magnitude of heavy metal pollution in this urban river sediment. Results revealed that the I geo of Pb indicated unpolluted to moderately polluted sediment at most of the sampling stations, whereas Zn was considered to be within background concentration. The I geo results were refined by the C f values, which showed Pb with very high C f at 12 stations. Zinc, on the other hand, had low to moderate C f values. These findings indicated that the sediment of the Langat River is severely polluted with Pb. The Zn concentration at most sampling points was well below most sediment quality guidelines. However, 40% of the sampling points were found to have a Pb concentration higher than the consensus-based probable effect concentration of 128 mg/kg (concentrations above this value are likely to cause harmful effects). This result not only highlights the severity of Pb pollution in the sediment of the Langat River, but also the potential risk it poses to the environment.
    MeSH terms: Cations/chemistry; Electric Conductivity; Environmental Monitoring/methods; Hydrogen-Ion Concentration; Lead/analysis*; Malaysia; Oxidation-Reduction; Spectrophotometry, Atomic; Urbanization*; Water Pollutants, Chemical/analysis*; Zinc/analysis*; Geologic Sediments/chemistry*; Rivers/chemistry*; Salinity
  2. Wen WX, Lee SY, Siang R, Koh RY
    Adv Ther, 2017 06;34(6):1245-1269.
    PMID: 28484954 DOI: 10.1007/s12325-017-0547-2
    Fibrosis is a potentially debilitating disease with high morbidity rates. It is estimated that half of all deaths that occur in the USA are attributed to fibrotic disorders. Fibrotic disorders are characterized primarily by disruption in the extracellular matrix deposition and breakdown equilibrium, leading to the accumulation of excessive amounts of extracellular matrix. Given the potentially high prevalence of fibrosis and the paucity of agents currently available for the treatment of this disease, there is an urgent need for the identification of drugs that can be utilized to treat the disease. Pentoxifylline is a methylxanthine derivative that is currently approved for the treatment of vascular diseases, in particular, claudication. Pentoxifylline has three main properties: improving the rheological properties of blood, anti-inflammatory, and antioxidative. Recently, the effectiveness of pentoxifylline in the treatment of fibrosis via attenuating and reversing fibrotic lesions has been demonstrated in several clinical trials and animal studies. As a result of the limited availability of antifibrotic agents in the long-term treatment of fibrosis that can attenuate and even reverse fibrotic lesions effectively, it would be of particular importance to consider the potential clinical utility of pentoxifylline in the treatment of fibrosis. Thus, this paper discusses the evolving roles of pentoxifylline in the treatment of different types of fibrosis.
    MeSH terms: Animals; Anti-Inflammatory Agents/therapeutic use; Antioxidants/therapeutic use; Clinical Trials as Topic; Fibrosis/drug therapy*; Humans; Pentoxifylline/therapeutic use*; Platelet Aggregation Inhibitors/therapeutic use*; Drug Repositioning*
  3. Kuan JW, Su AT, Leong CF
    J Clin Apher, 2017 Dec;32(6):517-542.
    PMID: 28485020 DOI: 10.1002/jca.21550
    Granulocyte-colony stimulating factor (G-CSF) mobilizes and increases the amount of hematopoietic stem cells in peripheral blood, enabling its harvest by few apheresis procedures. The pegylated G-CSF has longer half-life and is given once only, which is more comfortable for patients, whereas the non-pegylated requires multiple daily injection because of its short half-life. We summarized results of randomized trials comparing the efficacy and safety of pegylated and non-pegylated G-CSF for peripheral blood stem cell mobilization. We searched the Cochrane CENTRAL, MEDLINE, EMBASE, and two conference proceedings. Two authors made the selection, extracted data and evaluated methodological quality using GRADE independently. We used random-effects model for meta-analysis. We found 3956 records and retrieved 47 full texts. We included eight randomized trials with a total number of 554 randomized and 532 analyzed subjects. The meta-analysis included five trials because not all trials reported the same outcomes. Pooling data from two studies shows no evidence for a difference in the successful mobilization rate (CD34+ cell ≥ 2 × 106 /kg collected) between pegfilgrastim 6 mg (early administration) and filgrastim 5 µg/kg/day (147 participants; risk ratio (RR) 0.87, 95% confidence interval (95%CI) 0.67-1.11; P = .26). Pooling data from three studies shows no difference in the incidence of adverse events between pegylated and non-pegylated G-CSF (170 participants; RR 0.86, 95%CI 0.34-2.17; P = .75). No difference found on the quantity of CD34+ cells collected, number of apheresis procedure in successful mobilization, level of peak PB CD34+ cells achieved, and day of neutrophil and platelet engraftment.
    MeSH terms: Filgrastim/adverse effects; Filgrastim/pharmacology*; Filgrastim/therapeutic use; Humans; Polyethylene Glycols/adverse effects; Polyethylene Glycols/pharmacology*; Polyethylene Glycols/therapeutic use; Randomized Controlled Trials as Topic; Antigens, CD34/analysis; Hematopoietic Stem Cell Mobilization/methods*; Peripheral Blood Stem Cells/cytology
  4. Megahed AA, Hiew MWH, Townsend JR, Constable PD
    Vet Clin Pathol, 2017 Jun;46(2):314-325.
    PMID: 28485837 DOI: 10.1111/vcp.12493
    BACKGROUND: The Precision Xtra electrochemical meter is widely used to measure blood β-hydroxybutyrate concentration (BHBb) in dairy cattle. The meter uses an algorithm optimized for human blood that assumes the HCT in cattle is the same as in people, and that intra-erythrocyte β-hydroxybutyrate (BHBe) and plasma β-hydroxybutyrate (BHBp) concentration are equivalent.

    OBJECTIVES: The first objective was to characterize the analytic performance of the meter for measuring BHBb and BHBp in dairy cattle. The second objective was to characterize the influence of HCT and sample temperature on BHBp concentration measured by the meter.

    METHODS: Blood and plasma samples were obtained from 106 periparturient Holstein cattle and 15 lactating Holstein cows with experimentally induced electrolyte and acid-base imbalances. Meter performance was evaluated using Deming regression and Bland-Altman plots. Multivariable linear regression was used to determine the effect of HCT and sample temperature on BHBb and BHBp concentration, respectively.

    RESULTS: The meter was linear up to BHB = 3.0 mmol/L as measured by the reference method, equivalent to meter values for BHBb > 4.5 mmol/L and BHBp > 5.2 mmol/L. An increase in HCT resulted in higher BHBb concentration. This result was partially explained by BHBe being much lower than BHBp. Changes in sample temperature caused a linear change in measured BHBp whenever BHBp > 3.0 mmol/L.

    CONCLUSIONS: Meter accuracy was markedly dependent on the BHBe-to-BHBp ratio and consequently the HCT. Therefore, the algorithm used by the meter should be revised when applied to bovine blood for improved accuracy.

  5. Siau CS, Wee LH, Ibrahim N, Visvalingam U, Wahab S
    Inquiry, 2017 01 01;54:46958017707295.
    PMID: 28486042 DOI: 10.1177/0046958017707295
    Understanding attitudes toward suicide, especially among healthcare personnel, is an important step in both suicide prevention and treatment. We document the adaptation process and establish the validity and reliability of the Attitudes Toward Suicide (ATTS) questionnaire among 262 healthcare personnel in 2 major public hospitals in the Klang Valley, Malaysia. The findings indicate that healthcare personnel in Malaysia have unique constructs on suicide attitude, compared with the original study on a Western European sample. The adapted Malay ATTS questionnaire demonstrates adequate reliability and validity for use among healthcare personnel in Malaysia.
    MeSH terms: Attitude of Health Personnel*; Cross-Sectional Studies; Cross-Cultural Comparison*; Female; Humans; Malaysia; Male; Surveys and Questionnaires/standards*; Suicide/prevention & control*; Reproducibility of Results; Young Adult
  6. Zin SRM, Kassim NM, Alshawsh MA, Hashim NE, Mohamed Z
    Biomed Pharmacother, 2017 Jul;91:611-620.
    PMID: 28486192 DOI: 10.1016/j.biopha.2017.05.011
    Anastatica hierochuntica L. (A. hierochuntica) is a desert plant consumed by people across the globe to treat various medical conditions. This review is aimed at providing a summary of the scientific findings on biological activities of A. hierochuntica and suggests areas in which further research is needed. This systematic review was synthesized from the literature obtained from the following databases; PubMed, Science Direct, Web of Science, Ovid Medline, Scopus, Google Scholar and WorldCat. Previous studies have indicated that the methanolic and aqueous extracts of this plant have antioxidant, antifungal and antimicrobial activities. It was shown to have the ability to activate phagocytes and to possess microbicidal activity, thereby causing increased resistance to infection. Both methanolic and aqueous extracts of this plant were also demonstrated to have a hypoglycaemic property, whilst the methanolic extract significantly exhibited hypolipidaemic effects in diabetic rats. Moreover, the methanolic extract of A. hierochuntica has been suggested to have hepatoprotective properties. This is supported by its ability to significantly decrease transaminase and alkaline phosphatase activities in alloxan-induced diabetic rats. Besides, this desert plant exhibited anti-inflammatory, anti-melanogenic and gastroprotective activities. Even though A. hierochuntica is widely used, studies on this plant are still scarce, thus its reputed biological activities and medical benefits require critical evaluation. Before A. hierochuntica can be used clinically, further studies need to be conducted to increase our understanding of the effects of this plant, its constituents, and possible mechanisms of action.
    MeSH terms: Methanol; Alkaline Phosphatase; Alloxan; Transaminases; Animals; Anti-Inflammatory Agents; Antifungal Agents; Antioxidants; Diabetes Mellitus, Experimental; Hypoglycemic Agents; Indoles; Melanins; Bibliometrics; MEDLINE; PubMed; Rats
  7. Noman AHM, Gee CS, Isa CR
    PLoS One, 2017;12(5):e0176546.
    PMID: 28486548 DOI: 10.1371/journal.pone.0176546
    This study examines the influence of competition on the financial stability of the commercial banks of Association of Southeast Asian Nation (ASEAN) over the 1990 to 2014 period. Panzar-Rosse H-statistic, Lerner index and Herfindahl-Hirschman Index (HHI) are used as measures of competition, while Z-score, non-performing loan (NPL) ratio and equity ratio are used as measures of financial stability. Two-step system Generalized Method of Moments (GMM) estimates demonstrate that competition measured by H-statistic is positively related to Z-score and equity ratio, and negatively related to non-performing loan ratio. Conversely, market power measured by Lerner index is negatively related to Z-score and equity ratio and positively related to NPL ratio. These results strongly support the competition-stability view for ASEAN banks. We also capture the non-linear relationship between competition and financial stability by incorporating a quadratic term of competition in our models. The results show that the coefficient of the quadratic term of H-statistic is negative for the Z-score model given a positive coefficient of the linear term in the same model. These results support the non-linear relationship between competition and financial stability of the banking sector. The study contains significant policy implications for improving the financial stability of the commercial banks.
    MeSH terms: Banking, Personal*; Asia, Southeastern; Economic Competition*; Empirical Research
  8. Lee YF
    Med J Malaysia, 2017 04;72(2):89-90.
    PMID: 28473669
    No abstract available.
    MeSH terms: Humans; Quality of Health Care; Medical Errors/prevention & control; Patient Safety*
  9. Leong BDK, Govindarajanthran N, Hafizan TM, Tan KL, Hanif H, Zainal AA
    Med J Malaysia, 2017 04;72(2):91-93.
    PMID: 28473670 MyJurnal
    INTRODUCTION: There has been a paradigm shift in the treatment of AAA with the advent of endovascular aneurysm repair (EVAR). Rapid progress and evolution of endovascular technology has brought forth smaller profile devices and closure devices. Total percutaneous endovascular aneurysm repair (pEVAR) involves the usage of suture-mediated closure devices (SMCDs) at vascular access sites to avoid a traditional surgical cutdown.

    MATERIALS AND METHODS: We retrospectively reviewed our experience of pEVAR between April 2013 and July 2014. Primary success of the procedure was defined as closure of a common femoral artery (CFA) arteriotomy without the need for any secondary surgical or endovascular procedure within 30 days.

    RESULTS: In total there were 10 pEVAR cases performed in the study period, one case in Queen Elizabeth Hospital during visiting vascular service. Patients have a mean age of 73.4 year old (66-77 year old) The mean abdominal aortic size was 7.2 cm (5.6-10.0cm). Mean femoral artery diameter was 9.0 mm on the right and 8.9 mm on the left. Mean duration of surgery was 119 minutes (98- 153 minutes). 50% of patients were discharged at post-operative day one, 30%- day two and 20%- day three. Primary success was achieved in 9 patients (90%) or in 19 CFA closures (95%). No major complication was reported.

    DISCUSSION: We believe that with proper selection of patients undergoing EVAR, pEVAR offers a better option of vascular access with shorter operative time, less post- operative pain, shorter hospital stay and minimises the potential complications of a conventional femoral cutdown.

    MeSH terms: Aged; Female; Humans; Malaysia; Retrospective Studies; Treatment Outcome; Aortic Aneurysm, Abdominal/surgery*; Vascular Closure Devices
  10. Abdullah B, Moize B, Ismail BA, Zamri M, Mohd Nasir NF
    Med J Malaysia, 2017 04;72(2):94-99.
    PMID: 28473671
    INTRODUCTION: This study aimed to determine the prevalence of menopausal symptoms, its effect to the quality of life and their treatment seeking behaviour in a multiracial community in Malaysia.

    METHODS: This is a cross-sectional study involving postmenopausal women in Klang Valley, Malaysia. Data was obtained by face-to-face interview using standardised questionnaires on sociodemographic data, Menopause Rating Scale questionnaire, effect to quality of life and treatment sought.

    RESULTS: A total of 258 women, including Malays (82%), Indians (14.1%) and Chinese (3.9%) were recruited. The median age was 58 (range 45-86) years old. Joint and muscular discomfort (73.3%) and fatigue (59.3%) were the most prevalent symptoms. Significant association with ethnicity were demonstrated with Malays was found to have 3.1 times higher incidence of sexual problems than Indians, (Odds Ratio (OR) 3.103; 95%CI 1.209, 7.967) and Indian had 2.6 times higher incidence of irritability compared to Malays (OR 2.598; 95%CI 1.126, 5.992). Fifty-two percent of women felt that menopausal symptoms affected their quality of life but there were only 2.7% who were severely affected. There were 24.8% of women who sought treatment and only 20.3% of those who took hormone replacement therapy. There was no significant association found between their treatment seeking behaviour in association with ethnicity, age, parity, marital and occupational status.

    CONCLUSION: Menopausal symptoms were prevalent among menopausal women, although only a small group of women who were severely affected. There was a lack of tendency in seeking treatment for menopausal symptoms among the women.
    MeSH terms: Aged; Aged, 80 and over; Cross-Sectional Studies; Female; Humans; Malaysia/epidemiology; Menopause*; Middle Aged; Quality of Life*; Surveys and Questionnaires; Prevalence
  11. Rashizal Sazli MR, Syed Mohamed AF, Wan Mazuan WM, Ling SM, Mahmud A, Amin Nordin S
    Med J Malaysia, 2017 04;72(2):100-105.
    PMID: 28473672 MyJurnal
    INTRODUCTION: The increasing trend of extensively drugresistant gram negative bacteria responsible for nosocomial infections has prompted resurgence colistin usage. Colistin-induced nephrotoxicity is a concern with disparity in the reported rates between previous studies. This study aims to evaluate colistin-induced nephrotoxicity among Malaysian population.

    METHODS: The medical records of ICU patients receiving colistin therapy in Hospital Serdang and Hospital Sungai Buloh from 2010 to 2012 were retrospectively reviewed. Demographics data, treatment characteristic as well as culture result and creatinine level were documented. Nephrotoxicity was determined based on RIFLE criteria.

    RESULTS: A total of 100 patients were included. Median daily dose, cumulative dose and duration of colistin therapy were 3.0 MIU (IQR: 4, range 1-12), 17.8 MIU (IQR: 31.5, range 2-180) and seven days (IQR: 4, range 1-30). Nephrotoxicity was found in 23% of the study population. All cases were reversible but marginally associated with higher mortality. No statistical association exist between age, gender and race as well as administration routes with nephrotoxicity by univariable analysis. The association of dose and duration with nephrotoxicity was also not significant by univariable analysis. After adjustment for confounders, statistical association between the independent variables and dependent variable remains not significant.

    CONCLUSION: Lower dose and shorter duration in local settings contribute to lack of association between colistin therapy and nephrotoxicity in this study. Higher dosing regimen with loading dose application has been introduced in the latest National Antibiotic Guideline. Further evaluation of colistin-induced nephrotoxicity and potential risk factors is therefore warranted.

    MeSH terms: Adult; Anti-Bacterial Agents/administration & dosage; Anti-Bacterial Agents/adverse effects*; Colistin/administration & dosage; Colistin/adverse effects*; Cross Infection/drug therapy; Female; Humans; Intensive Care Units/statistics & numerical data*; Malaysia/epidemiology; Male; Middle Aged; Retrospective Studies; Risk Factors; Acute Kidney Injury/chemically induced*
  12. Ariffin F, Ramli AS, Daud MH, Haniff J, Abdul-Razak S, Selvarajah S, et al.
    Med J Malaysia, 2017 04;72(2):106-112.
    PMID: 28473673 MyJurnal
    INTRODUCTION: Non-communicable diseases (NCD) is a global health threat. the Chronic Care Model (CCM) was proven effective in improving NCD management and outcomes in developed countries. Evidence from developing countries including Malaysia is limited and feasibility of CCM implementation has not been assessed. this study intends to assess the feasibility of public primary health care clinics (PHC) in providing care according to the CCM.

    METHODOLOGY: A cross-sectional survey was conducted to assess the public PHC ability to implement the components of CCM. All public PHC with Family Medicine Specialist in Selangor and Kuala Lumpur were invited to participate. A site feasibility questionnaire was distributed to collect site investigator and clinic information as well as delivery of care for diabetes and hypertension.

    RESULTS: there were a total of 34 public PHC invited to participate with a response rate of 100%. there were 20 urban and 14 suburban clinics. the average number of patients seen per day ranged between 250-1000 patients. the clinic has a good mix of multidisciplinary team members. All clinics had a diabetic registry and 73.5% had a hypertensive registry. 23.5% had a dedicated diabetes and 26.5% had a dedicated hypertension clinic with most clinic implementing integrated care of acute and NCD cases.

    DISCUSSION: the implementation of the essential components of CCM is feasible in public PHCs, despite various constraints. Although variations in delivery of care exists, majority of the clinics have adequate staff that were willing to be trained and are committed to improving patient care.
    MeSH terms: Ambulatory Care Facilities; Chronic Disease/therapy*; Cross-Sectional Studies; Diabetes Mellitus/therapy; Feasibility Studies; Humans; Hypertension/therapy; Malaysia; Primary Health Care/methods; Primary Health Care/organization & administration*; Surveys and Questionnaires; Models, Organizational
  13. How KN, Tang MM, Kaur R, Johar A
    Med J Malaysia, 2017 04;72(2):113-118.
    PMID: 28473674 MyJurnal
    BACKGROUND: The pattern of contact sensitisation should be monitored in order to detect the changing trend of sensitising allergens. We aim to evaluate contact sensitisation in adults suspected to have allergic contact dermatitis.

    METHODS: This is a five-year retrospective review on contact sensitisation in adults patch-tested with the European Standard and extended series between 2011 and 2015 in the Department of Dermatology, Hospital Kuala Lumpur.

    RESULTS: There were 689 adults (M:F= 1:2.04; mean age 40.5 years) who were patch-tested. The majority (175, 25.4%) were white collar workers and 118 (17.1%) were healthcare workers. The provisional diagnoses of patients included contact dermatitis (80.8%); endogenous eczema (7.9%); hand eczema (3.2%); hand and foot eczema (3.5%); foot eczema (1.4%) and photodermatitis (1.2%). The allergens selected for testing were based on past and present history of exposure. Almost all (688, 99.8%) were patch-tested with the European standard allergens and 466 (67.6%) were tested with the extended series. About three quarter (528, 76.6%) developed at least one positive reaction. The top five most frequent reactions were to nickel sulphate (35.3%); potassium dichromate (16.5%); methylchloroisothiazolinone (12.9%), fragrance mix I (12.6%), and cobalt chloride (10.2%). The commonest sensitisations identified in the extended series were palladium chloride (23/105, 21.9%), stannous chloride (18/85, 21.2%), miconazole (7/44, 15.9%), gold(I)sodium thiosulfate (16/105, 15.2%) and thimerosal (29/202, 14.4%).

    CONCLUSION: Contact sensitisation was detected in 76.6% of adults patch-tested. Nickel sulphate was found to be the most frequently sensitising allergen. The rising prevalence of methylchloroisothiazolinone/methylisothiazolinone sensitization poses significant concern.

    MeSH terms: Adolescent; Adult; Aged; Female; Humans; Malaysia/epidemiology; Male; Middle Aged; Patch Tests; Retrospective Studies; Prevalence; Dermatitis, Allergic Contact/diagnosis; Dermatitis, Allergic Contact/etiology; Dermatitis, Allergic Contact/epidemiology*; Young Adult
  14. Singh DKA, Rahman NNA, Seffiyah R, Chang SY, Zainura AK, Aida SR, et al.
    Med J Malaysia, 2017 04;72(2):119-121.
    PMID: 28473675 MyJurnal
    INTRODUCTION: There is limited information regarding the effects of interactive virtual reality (VR) games on psychological and physical well-being among adults with physical disabilities. We aimed to examine the impact of VR games on psychological well-being, upper limb motor function and reaction time in adults with physical disabilities.

    METHODS: Fifteen participants completed the intervention using Wii VR games in this pilot study. Depressive, Anxiety and Stress Scales (DASS) and Capabilities of Upper Extremity (CUE) questionnaires were used to measure psychological well-being and upper limb motor function respectively. Upper limb reaction time was measured using reaction time test.

    RESULTS: Results showed that there was a significant difference (p<0.05) in DASS questionnaire and average reaction time score after intervention.

    CONCLUSION: There is a potential for using interactive VR games as an exercise tool to improve psychological wellbeing and upper limb reaction time among adults with disabilities.

    MeSH terms: Emotional Adjustment*; Arm/physiology*; Female; Disabled Persons/psychology; Disabled Persons/rehabilitation*; Humans; Male; Pilot Projects; Reaction Time; Young Adult
  15. Tang ASO, Yong KY, Wong J, Chua HH, Chew LP
    Med J Malaysia, 2017 04;72(2):122-123.
    PMID: 28473676
    This is a case report of subcutaneous mycosis presenting as a non-healing left calf ulcer in an immunocompromised patient. Traumatic inoculation of the causative agent is the most likely route of infection. The diagnosis requires a detailed history and high clinical suspicion, confirmed by histopathological examination. The management requires a multidisciplinary team approach involving surgeon, pathologist, physician sub-specialised in infectious disease, wound care nursing team as well as social support services. The literature review recommended that the treatment of choice for such infection is surgical debridement in addition to optimal antifungal therapy.
    MeSH terms: Adult; Diagnosis, Differential; Humans; Leg*; Male; Skin Ulcer/diagnosis*; Skin Ulcer/etiology; Skin Ulcer/pathology; Immunocompromised Host*; Invasive Fungal Infections/complications; Invasive Fungal Infections/diagnosis*; Invasive Fungal Infections/pathology
  16. Gan SP, Ong SG
    Med J Malaysia, 2017 04;72(2):124-125.
    PMID: 28473677 MyJurnal
    A pregnant woman with antiphospholipid syndrome presented with repeated venous thromboembolism (VTE) in the first and second trimesters of pregnancy despite receiving combination therapy with low-molecular-weight heparin and aspirin. The addition of hydroxychloroquine prevented further VTE recurrence, thus demonstrating its potential antithrombotic effects.
    MeSH terms: Antithrombins/therapeutic use*; Female; Humans; Hydroxychloroquine/therapeutic use*; Pregnancy; Pregnancy Complications/drug therapy*; Pregnancy Complications/immunology; Pregnancy Complications, Cardiovascular/drug therapy*; Recurrence; Antiphospholipid Syndrome/complications*; Antiphospholipid Syndrome/drug therapy; Venous Thromboembolism/complications*; Young Adult
  17. Yip KW, Cheng YKY, Leung TY
    Med J Malaysia, 2017 04;72(2):126-127.
    PMID: 28473678 MyJurnal
    In-utero intestinal volvulus is a rare but potential life threatening foetal complications. It is a surgical emergency and delay in diagnosis or treatment can increase the morbidity and mortality to the foetus. We report a case of mild foetal bowel dilatation diagnosed at 21 weeks of gestation. She was closely follow up and at 31 weeks of gestation, in-utero intestinal volvulus was diagnosed with the characteristic 'whirlpool' sign on ultrasound examination. This case emphasises the importance of early recognition and quick decision to delivery when intestinal volvulus is diagnosed. This enabled early surgical intervention to prevent further foetal morbidity.
    MeSH terms: Adult; Cesarean Section; Female; Humans; Male; Pregnancy; Ultrasonography, Prenatal*; Intestinal Volvulus/diagnosis; Intestinal Volvulus/embryology*; Intestinal Volvulus/surgery
  18. Michael A, Zakry Y, Hanif H
    Med J Malaysia, 2017 04;72(2):128-129.
    PMID: 28473679 MyJurnal
    Epiploic appendagitis or appendices epiploicae, is a rare cause of abdominal pain in patients with mild signs of abdominal pathology. It mimics diverticulitis or appendicitis clinically as there are no pathognomonic features. It is a surgical diagnosis presenting with localised, sharp, acute abdominal pain, not associated with symptoms like nausea, vomiting, fever or suggestive laboratory values. With the availability of abdominal CT scans and ultrasound, it will frequently be a differential diagnosis preventing unnecessary surgery for patients. However, it may be erroneous and therefore clinical judgement is of paramount importance. This report highlights this rare presentation and identifies management guidelines.
    MeSH terms: Adult; Colitis/diagnosis*; Colitis/pathology; Colitis/surgery; Colon/pathology; Colon/surgery; Diagnosis, Differential; Humans; Male; Tomography, X-Ray Computed
  19. Loh MA, Abirami S, Chong MF
    Med J Malaysia, 2017 04;72(2):130-132.
    PMID: 28473680 MyJurnal
    We report a rare case of central retinal vein occlusion (CRVO) in pregnancy. There was dramatic deterioration of vision in both eyes through pregnancy despite repeated attempts of laser treatment and systemically controlled diabetes. Significant improvement was noted postpartum. Pregnancy is an aggravated factor of bilateral CRVO.
    MeSH terms: Adult; Female; Fundus Oculi; Humans; Pregnancy; Pregnancy Complications/diagnosis*; Pregnancy Complications/pathology; Retinal Vein Occlusion/complications*; Retinal Vein Occlusion/diagnosis; Retinal Vein Occlusion/pathology
  20. Edawati DE, Abigail J, Mardiana K, Ming-Cheng C, Harris NS
    Med J Malaysia, 2017 04;72(2):133-134.
    PMID: 28473681 MyJurnal
    This case report discusses dumping syndrome in the postbariatric mother. Diagnostically a challenge, the symptoms of postprandial hypoglycaemia mimic common early gestation complaints and may go undiagnosed, thus requiring a high index of suspicion. As weight-loss surgery gains traction, it is pertinent to note at booking and followups. The pregnancy is at-risk and multidisciplinary team management is central. The mainstay of management remains diet modification. There have been case reports of successful medical treatment of dumping syndrome in pregnancy with good maternal and fetal outcomes. However, more data is needed regarding the usage of these medical treatments in pregnancy.
    MeSH terms: Adult; Cesarean Section; Dumping Syndrome/complications*; Dumping Syndrome/etiology; Female; Humans; Pregnancy; Pregnancy Complications/etiology*; Bariatric Surgery/adverse effects*
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