Displaying publications 1 - 20 of 55 in total

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  1. Amanullah I, Khan YH, Anwar I, Gulzar A, Mallhi TH, Raja AA
    Postgrad Med J, 2019 Nov;95(1129):601-611.
    PMID: 31434683 DOI: 10.1136/postgradmedj-2018-136364
    The efficacy of vitamin E among patients with non-alcoholic fatty liver disease (NAFLD) is unclear. The current qualitative and quantitative analyses aimed to ascertain the efficacy of vitamin E on clinical outcomes of patients with NAFLD. A systematic search of randomised controlled trials (RCTs) was performed using databases (PubMed, ProQuest, Scopus, EBSCOhost and Ovid) from inception to July 2018. Trials meeting the inclusion criteria were subjected to quality assessment using the Jadad Scoring. All trials meeting the prerequisites information for meta-analysis were subjected to quantitative synthesis of results. Nine RCTs (five in adults and four in children) were included. Four of the five RCTs on adults demonstrated significant improvements in alanine transaminase and other liver function surrogates in patients with NAFLD. On the other hand, only one of the four RCTs conducted on children showed significant improvements in liver functions with the use of vitamin E. Although quantitative synthesis of available data revealed insignificant differences between vitamin E and placebo, still the use of vitamin E improves the level of alanine transaminase and aspartate transaminase by -1.96 and -0.59, with heterogeneity of I2=67% and I2=0%, respectively. Adjuvant vitamin E therapy provides significant biochemical and histological improvements in adult patients with NAFLD, while paediatric patients showed insignificant efficacy compared with placebo. Lifestyle interventions along with vitamin E can provide much better results. Data, including the impact of vitamin E on hepatic histology, are still lacking. Moreover, the short duration of trials limits the conclusion on the safety and efficacy of proposed treatments.
  2. Awuah WA, Ng JC, Mehta A, Nansubuga EP, Abdul-Rahman T, Kundu M, et al.
    Postgrad Med J, 2023 Aug 22;99(1175):941-945.
    PMID: 37280156 DOI: 10.1093/postmj/qgad043
    With increasing prevalence and an expected rise in disease burden, cancer is a cause of concern for African healthcare. The cancer burden in Africa is expected to rise to 2.1 million new cases per year and 1.4 million deaths annually by the year 2040. Even though efforts are being made to improve the standard of oncology service delivery in Africa, the current state of cancer care is not yet on par with the rise in the cancer burden. Cutting-edge technologies and innovations are being developed across the globe to augment the battle against cancer; however, many of them are beyond the reach of African countries. Modern oncology innovations targeted to ward Africa would be promising to address the high cancer mortality rates. The innovations should be cost-effective and widely accessible to tackle the rapidly rising mortality rate on the African continent. Though it may seem promising, a multidisciplinary approach is required to overcome the challenges associated with the development and implementation of modern oncology innovations in Africa.
  3. Awuah WA, Tenkorang PO, Adebusoye FT, Ng JC, Wellington J, Abdul-Rahman T, et al.
    Postgrad Med J, 2023 Dec 21;100(1179):1-3.
    PMID: 37857514 DOI: 10.1093/postmj/qgad100
  4. Azarisman MS, Fauzi MA, Faizal MP, Azami Z, Roslina AM, Roslan H
    Postgrad Med J, 2007 Jul;83(981):492-7.
    PMID: 17621621
    BACKGROUND: This study was proposed to develop a composite of outcome measures using forced expiratory volume percentage of predicted, exercise capacity and quality of life scores for assessment of chronic obstructive pulmonary disease (COPD) severity.
    MATERIALS AND METHODS: Eighty-six patients with COPD were enrolled into a prospective, observational study at the respiratory outpatient clinic, National University Hospital Malaysia (Hospital Universiti Kebangsaan Malaysia--HUKM), Kuala Lumpur.
    RESULTS: Our study found modest correlation between the forced expiratory volume in 1 s (FEV(1)), 6 min walk distance and the SGRQ scores with mean (SD) values of 0.97 (0.56) litres/s, 322 (87) m and 43.7 (23.6)%, respectively. K-Means cluster analysis identified four distinct clusters which reached statistical significance which was refined to develop a new cumulative staging system. The SAFE Index score correlated with the number of exacerbations in 2 years (r = 0.497, p<0.001).
    CONCLUSION: We have developed the SGRQ, Air-Flow limitation and Exercise tolerance Index (SAFE Index) for the stratification of severity in COPD. This index incorporates the SGRQ score, the FEV(1) % predicted and the 6 min walk distance. The SAFE Index is moderately correlated with the number of disease exacerbations.
    Study site: Respiratory clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
  5. Bhardwaj A, Nagandla K
    Postgrad Med J, 2014 Aug;90(1066):450-60.
    PMID: 24904047 DOI: 10.1136/postgradmedj-2013-132377
    Low back pain is a common musculoskeletal symptom in pregnancy that can present as lumbar pain or pelvic girdle pain, with significant physical and psychosocial implications. Pelvic girdle pain is more prevalent and results in greater disability than lumbar pain. It is possible to distinguish between these two conditions from a detailed history based on the site of the pain, its intensity, disability and pain provocation tests. Management of low back pain in pregnancy is conservative, with physical exercise for lumbar pain and minimising activities that exacerbate pain, analgesics and bed rest for pelvic girdle pain, as well as avoiding abduction beyond the pain-free zone in labour. There is evidence that stabilising exercises in patients with pelvic girdle pain postpartum have a beneficial effect. Other treatment modalities that have been shown to be safe and effective include pelvic belts, transcutaneous electrical nerve stimulation, spinal manipulative therapy, acupuncture and complementary therapy with yoga. Other orthopaedic complications in pregnancy such as carpal tunnel syndrome, pubic symphysis rupture, transient osteoporosis and osteonecrosis are usually self-limiting with a satisfactory outcome. However, a lack of awareness and failure to recognise these complications can result in long-term morbidity. Knowledge of the preoperative diagnostic investigations, surgical approaches and intraoperative positioning of the mother to avoid gravid uterus compression is vital in orthopaedic emergencies such as lumbar disc herniation, cauda equina syndrome, fractures and acute compartment syndrome of the lower limb to ensure a safe maternal and fetal outcome and to prevent serious disability. Pregnancy is not contraindicated in women with pre-existing orthopaedic complications such as kyphoscoliosis and total hip arthroplasty as there is no evidence to suggest increased maternal or fetal risks.
  6. Biswal BM, Madhavan M, Anas SR
    Postgrad Med J, 2000 Nov;76(901):719-20, 728-9.
    PMID: 11060156
  7. Chong KC
    Postgrad Med J, 1976 Aug;52(610):504-10.
    PMID: 824633
    The incidence, clinical features and pathology of nine cases of diverticula of the appendix in Malaysians are reported. The findings are discussed and compared with those previously reported. The pathogenesis of the lesion in eight cases is unknown. The rare association of lumenal obstruction by a carcinoid tumour and diverticulum formation in the appendix is seen in one case.
  8. Cronin C, Lucas M, McCarthy A, Boland F, Varadarajan R, Premnath N, et al.
    Postgrad Med J, 2019 Mar;95(1121):119-124.
    PMID: 30975724 DOI: 10.1136/postgradmedj-2018-136136
    BACKGROUND: A survey of medical students from the Royal College of Surgeons in Ireland (RCSI) at Dublin, Perdana and Penang in Malaysia was undertaken in an attempt to explore attitudes towards a career in surgery and document potential differences between male and female students' perceptions of a surgical career.

    METHOD: A hyperlink to an online, anonymised questionnaire was distributed to medical students in 3rd, 4th and final year at three RCSI campuses. Basic descriptive statistics were used to describe the responses to individual questions and appropriate statistical tests used to compare male and female responses to questions.

    RESULTS: A total of 464 completed questionnaires were analysed. Almost 40% (n=185) were male and 60% (n=279) were female. Males were significantly more influenced by remuneration than females (p<0.001) towards a choice of surgical career. Females were significantly more influenced in their choice of surgical career by part-time work (p<0.001), parental leave (p<0.001), working hours (p<0.001) and length of residency (p=0.003). During surgical attachments, females were significantly more likely to admit feeling intimidated than males (p=0.002) and males more likely to report feeling confident (p<0.001). Ninety-six per cent of students felt they would be more likely to pursue a career in which they had identified a positive role model, with female medical students three times more likely to have identified a female role model than males.

    CONCLUSION: According to our study, preference for a career in surgery declines with advancing years in medical school for both males and females. Medical students report high levels of feeling intimidated or ignored during their surgical placements, and enthusiasm for surgery reduces during medical school with exposure to this. These findings, along with the importance of role modelling, add further urgency to the need to address factors which make surgery less appealing to female medical graduates.

  9. Fadilah SA, Raymond AA, Cheong SK
    Postgrad Med J, 2001 Apr;77(906):268-269; discussion 277-8.
    PMID: 11264499
  10. Fadilah SA, Cheong SK, Maimunah A, Toh ST, Shamin AS
    Postgrad Med J, 2001 Nov;77(913):733-4, 737-9.
    PMID: 11677287
  11. Goh KL, Wong NW, Paramsothy M, Nojeg M, Somasundaram K
    Postgrad Med J, 1987 Jul;63(741):551-4.
    PMID: 3658864
    We reviewed 204 cases of liver abscess seen between 1970 and 1985. Ninety were found to be amoebic, 24 pyogenic and one tuberculous. The cause of the abscesses in the remaining 89 patients was not established. The patients were predominantly male, Indians, and in the 30-60 age group. The majority of patients presented with fever and right hypochondrial pain. The most common laboratory findings were leucocytosis, hypoalbuminaemia and an elevated serum alkaline phosphatase. Amoebic abscesses were mainly solitary while pyogenic abscesses were mainly multiple. Complications were few in our patients and included rupture into the pleural and peritoneal cavities and septicaemic shock. An overall mortality of 2.9% was recorded. The difficulty in diagnosing the abscess type is highlighted. The single most important test in helping us diagnose amoebic abscess, presumably the most common type of abscess in the tropics, is the Entamoeba histolytica antibody assay. This test should be used more frequently in the tropics.
  12. Hung KK, Lin AK, Cheng CK, Chan EY, Graham CA
    Postgrad Med J, 2015 Mar;91(1073):127-31.
    PMID: 25673799 DOI: 10.1136/postgradmedj-2014-133126
    Malaria remains a significant cause of travel-related mortality and morbidity. Asians are known to have higher risks because they are less careful in pre-travel health preparations. This study reports on a cohort of travellers to malaria-prone regions examined in a previous study, which explored general levels of pre-travel health preparation.
  13. Jackson WP
    Postgrad Med J, 1972 Jul;48(561):391-8.
    PMID: 5069893 DOI: 10.1136/pgmj.48.561.391
    We have investigated the total prevalence of diabetes and related factors among representative, randomly chosen samples of the five ethnic groups living in Cape Town, and (East) Indians in Durban. Comparisons are hindered by differences in age distribution of the populations, while small, isolated groups were found to be unrepresentative. The variability of a single individual's blood sugar levels led us to require at least three abnormal values on 2 different days for a positive diagnosis. The use of different criteria for the diagnosis of diabetes varying from ‘lax’ to ‘stringent’ alters the discovered prevalence in our groups by the factor of approximately 2.

    Mean blood glucose levels rose with middle age but never between childhood and early adulthood. Afternoon screening tests appeared valid, despite the agreed diurnal difference in glucose tolerance figures.

    Both high screening blood glucose levels and diabetes itself were most common among Indians and coloured people and least among Whites and Bantu, each of the latter having a total diabetes prevalence of approximately 3·5% over age 15. It is noted that the Cape Coloured have more diabetes than any of the constituent races from which they originated.

    The reasons for such racial differences are unclear—obesity cannot be the explanation here, since, to take one example, the fattest group of all, the Bantu women, have the lowest prevalence of diabetes. We found mild diabetes not uncommon among young people under 20 in the Indian, Malay and coloured population but none among White or Bantu. There was little difference between the sexes, and if anything the poorer people had more diabetes than the better-off.
  14. Jalleh RP, Pathmanathan R, Krishnan MM, Mukherjee A
    Postgrad Med J, 1988 Sep;64(755):669-71.
    PMID: 3251217
    Four cases of anorectal melanoma are presented. The authors believe that this is the first report of the occurrence of this tumour in Malays. Advanced disease at initial presentation accounts for the poor prognosis observed in this series. Surgery remains the principal treatment modality, although controversy exists regarding optimal extent of resection.
  15. Kalam N, Balasubramaniam VRMT
    Postgrad Med J, 2024 Mar 16.
    PMID: 38493312 DOI: 10.1093/postmj/qgae030
    The microbes in the gut are crucial for maintaining the body's immune system and overall gut health. However, it is not fully understood how an unstable gut environment can lead to more severe cases of SARS-CoV-2 infection. The gut microbiota also plays a role in the gut-brain axis and interacts with the central nervous system through metabolic and neuroendocrine pathways. The interaction between the microbiota and the host's body involves hormonal, immune, and neural pathways, and any disruption in the balance of gut bacteria can lead to dysbiosis, which contributes to pathogen growth. In this context, we discuss how dysbiosis could contribute to comorbidities that increase susceptibility to SARS-CoV-2. Probiotics and fecal microbiota transplantation have successfully treated infectious and non-infectious inflammatory-related diseases, the most common comorbidities. These treatments could be adjuvant therapies for COVID-19 infection by restoring gut homeostasis and balancing the gut microbiota.
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