Displaying publications 1 - 20 of 925 in total

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  1. Ab Hamid J, Mohtarrudin N, Osman M, Andi Asri AA, Wan Hassan WH, Aziz R
    Singapore Med J, 2012 Oct;53(10):681-3.
    PMID: 23112021
    Gestational hypertension (GH) is a common disorder during pregnancy that can progress to preeclampsia and cause various subsequent fatal complications. A cluster of enzymes, called matrix metalloproteinases (MMPs), and its specific inhibitors, tissue inhibitors of metalloproteinases (TIMPs), have been reported to be involved in the pathophysiology of GH. The purpose of this study was to examine circulating levels of MMP-9, TIMP-1 and TIMP-2 in pregnant women who had GH and those who were normotensive.
  2. Ab Hamid S, Wastie ML
    Singapore Med J, 2008 Mar;49(3):e73-5.
    PMID: 18362991
    We report a 43-year-old woman who presented with post-coital bleeding. Pelvic examination revealed a uterine cervical mass, which confirmed to be large B cell lymphoma on histopathological examination. Computed tomography showed a primary lesion in the uterine cervix with no lymph node or other extranodal involvement. The patient responded to CHOP (cyclophosphamide, adriamycin, vincristine and prednisolone) chemotherapy regime with no major side effects.
  3. Abdul Ghani R, Zainudin S, Kamaruddin NA, Kong NC
    Singapore Med J, 2009 Jan;50(1):e32-4.
    PMID: 19224067
    Drug-induced acute interstitial nephritis is a well-recognised and important reversible cause of acute renal failure. Peroxisome-proliferator activated receptor-gamma agonists, such as rosiglitazone, have been proven to be safe in chronic kidney disease patients. We describe a 65-year-old man with long-standing diabetes mellitus and hypertension, presenting with a five-day history of fluid overload and uraemic symptoms. There was no ingestion of analgesics, alternative medicine and other nephrotoxic drugs, the only new prescription being rosiglitazone, which was commenced during his last clinic follow-up two weeks prior to presentation. He required haemodialysis with minimal improvement in renal profile, despite cessation of the offending drug. Renal biopsy revealed findings consistent with acute interstitial nephritis. An episode of upper gastrointestinal bleeding with bleeding duodenal ulcer limited the use of steroids. He was treated with a course of mycophenolate mofetil which showed good gradual response and he remained stable with residual renal impairment.
  4. Abdul Jalil N, Abdul Rahim N, Md Shalleh N, Rossetti C
    Singapore Med J, 2008 Jul;49(7):e178-82.
    PMID: 18695852
    A majority of the clinical use of positron emission tomography (PET)-computed tomography (CT) is related to cancer management. Its application in evaluating inflammatory diseases and pyrexia of unknown origin is becoming popular. We reviewed the fluorine-18-fluorodeoxyglucose PET-CT findings of an 80-year-old woman with nonspecific clinical presentation consisting of generalised malaise, moderately high fever and weight loss. Prior CT and magnetic resonance imaging were not helpful in providing a clinical diagnosis. The diagnosis was Horton's arteritis, and the patient responded well to high-dose steroids.
  5. Abdul-Rahman NR, Mohammad KF, Ibrahim S
    Singapore Med J, 2009 Jun;50(6):e223-5.
    PMID: 19551303
    The Klippel-Trenaunay syndrome is a combination of venous and capillary malformations associated with soft tissue and/or bony limb hypertrophy, with or without lymphatic malformations. Although persistent foetal veins are rare, the persistence of the lateral marginal vein is a common association in this syndrome. It results in venous hypertension, which gives rise to venous varicosities, which are commonly seen in this syndrome. This is a case report of a 28-year-old man with Klippel-Trenaunay syndrome, with persistence of the lateral marginal vein, affecting his right lower limb. He was treated with an above-knee amputation. The amputated limb was dissected to demonstrate the anatomy of the lateral marginal vein. To the best of the authors' knowledge, the gross anatomy of the lateral marginal vein has not been previously reported.
  6. Abdul-Wahab J, Naznin M, Suhaimi A, Amir-Hamzah AR
    Singapore Med J, 2007 Jul;48(7):e206-8.
    PMID: 17609817
    Familial myelodysplastic syndrome occurring at a young age is a very rare childhood haematological malignancy. Two siblings, aged three and 18 years, from a consanguineous marriage, presented with pancytopenia and was subsequently diagnosed to have myelodysplastic syndrome. Both remained clinically stable throughout the illness. Splenectomy appeared to have fully corrected the cytopenia in one of them.
  7. Abdullah A, Hazim MY, Almyzan A, Jamilah AG, Roslin S, Ann MT, et al.
    Singapore Med J, 2006 Jan;47(1):60-4.
    PMID: 16397723
    This study aims to determine the prevalence of hearing loss among newborns delivered at Hospital Universiti Kebangsaan Malaysia and to evaluate the usefulness of our hearing screening protocol.
  8. Abdullah HR, Ang AL, Froessler B, Hofmann A, Jang JH, Kim YW, et al.
    Singapore Med J, 2020 Jun;61(6):287-296.
    PMID: 31044255 DOI: 10.11622/smedj.2019037
    Preoperative anaemia is common in the Asia-Pacific. Iron deficiency anaemia (IDA) is a risk factor that can be addressed under patient blood management (PBM) Pillar 1, leading to reduced morbidity and mortality. We examined PBM implementation under four different healthcare systems, identified challenges and proposed several measures: (a) Test for anaemia once patients are scheduled for surgery. (b) Inform patients about risks of preoperative anaemia and benefits of treatment. (c) Treat IDA and replenish iron stores before surgery, using intravenous iron when oral treatment is ineffective, not tolerated or when rapid iron replenishment is needed; transfusion should not be the default management. (d) Harness support from multiple medical disciplines and relevant bodies to promote PBM implementation. (e) Demonstrate better outcomes and cost savings from reduced mortality and morbidity. Although PBM implementation may seem complex and daunting, it is feasible to start small. Implementing PBM Pillar 1, particularly in preoperative patients, is a sensible first step regardless of the healthcare setting.
  9. Abdullah JM, Rahman ZA, Ariff AR, Jaafar H, Phang KS
    Singapore Med J, 2004 Jun;45(6):286-8.
    PMID: 15181525
    Rhabdoid tumour is a rare childhood tumour with poor prognosis. We report a 13-month-old Malay girl suffering from this tumour that was located at the left fronto-temporo-parietal region of the brain. Computed tomography showed a large irregular enhancing mass that caused obstructive hydrocephalus. The tumour did not reduce in size after three operations and finally the patient succumbed to the disease four months after diagnosis.
  10. Abdullah S, Mat Nor NF, Mohamed Haflah NH
    Singapore Med J, 2014 Apr;55(4):e54-6.
    PMID: 24763843
    Melorheostosis is a rare, progressive bone disease accompanied by hyperostosis and soft tissue fibrosis. While affected adults present with contracture and pain, children present with limb length discrepancy and deformity. We report the case of a 20-year-old woman with melorheostosis since childhood who presented with right hand deformity and numbness. Radiographs showed not only a combination of dense sclerosis and opacities, but also the classic 'flowing candle wax' appearance. Radiography can be used to identify melorheostosis, thus preventing unnecessary bone biopsies. Carpal tunnel release revealed the presence of a thickened flexor retinaculum and a degenerated median nerve distal to the retinaculum, but did not show hyperostosis. This case highlights the role of nerve decompression in melorheostosis and the importance of early identification of the disease to prevent unnecessary bone biopsies.
  11. Abdullah WZ, Idris SZ, Bashkar S, Hassan R
    Singapore Med J, 2009 Jun;50(6):604-9.
    PMID: 19551314
    The fibrinolytic system plays an important role in normal haemostasis and endothelial function. This study was conducted to compare three fibrinolytic markers, i.e. plasminogen, tissue-plasminogen activator (t-PA) and plasminogen activator inhibitor type-1 (PAI-1) between acute stroke and stable non-stroke patients and to investigate the clinical significance of these markers.
  12. Abu Bakar NF, Chen AH, Md Noor AR, Goh PP
    Singapore Med J, 2012 Aug;53(8):541-4.
    PMID: 22941133
    The visual status of children with learning disabilities has not been extensively studied. This study aimed to compare vision disorders between children in mainstream classes and those with learning disabilities attending special education classes in government primary schools in Malaysia.
  13. Achanna S, Monga D
    Singapore Med J, 1994 Dec;35(6):605-8.
    PMID: 7761886
    The outcome of 100 patients undergoing instrumental delivery with vacuum extractor is compared with that of 100 women delivered with the aid of obstetric forceps. Forceps deliveries were more commonly associated with maternal birth canal trauma (including episiotomy) whilst vacuum extractor carried higher odds of the neonate developing jaundice. Apart from these, there were no significant differences between these two groups in terms of maternal morbidity, neonatal trauma and morbidity and ultimate outcome (success with the type of instrument used). We conclude that with meticulous handling of the instrument and with an appropriate decision on the indication and the type of instrument used, the maternal and neonatal outcome could be equally good with the use of either instrument.
  14. Adam N, Lim SS, Ananda V, Chan SP
    Singapore Med J, 2010 Jul;51(7):e129-32.
    PMID: 20730389
    Vasoactive intestinal peptide-producing tumour (VIPoma) or Verner-Morrison syndrome is a very rare neuroendocrine tumour. It occurs in less than ten percent of all pancreatic islet cell tumours, and about 70 percent to 80 percent of these tumours originate from the pancreas. Diagnosis is characteristically delayed. The first-line treatment is surgical. It may be curative in forty percent of patients with benign and non-metastatic disease. Palliative surgery is indicated in extensive disease, followed by conventional somatostatin analogue (octreotide) therapy. Somatostatin analogues improve hormone-mediated symptoms, reduce tumour bulk and prevent local and systemic effects. We present a female patient with VIPoma syndrome, which had metastasised to the liver at diagnosis. The patient underwent palliative Whipple procedure and subsequent cytoreductive radiofrequency ablations to her liver metastases. Unfortunately, after symptomatic improvement for three years, her disease progressed. Currently, she is on daily octreotide, achieving partial control of her symptoms.
  15. Adlina AR, Chong YJ, Shatriah I
    Singapore Med J, 2014 May;55(5):253-6.
    PMID: 24862748
    INTRODUCTION: Available data on traumatic cataract in Asian children is primarily confined to South Asian countries. We aimed to describe the demographics, nature of injury and visual outcomes of Malaysian children with traumatic cataract from a suburban area, and discuss the literature on Asian children with this condition.

    METHODS: We conducted a retrospective study of 29 children below 17 years of age who were diagnosed with traumatic paediatric cataract and who attended Hospital Universiti Sains Malaysia, Kelantan, Malaysia, between January 2000 and December 2010. Follow-up periods ranged from 12 to 120 months. Demographic data, clinical features, mechanism and extent of injury, and final visual outcome were recorded.

    RESULTS: The study population was predominantly male. The right eye was injured in 62.07% of patients. A majority of patients had penetrating injuries, with the most common cause being injury by an organic foreign body (24.14%). Presenting visual acuity worse than 6/60 was observed in 68.97% of patients. Only 34.48% of patients had a final corrected visual acuity of 6/12 and better. 55.18% of patients were operated on within less than one month of their injuries. A majority of children sustained concurrent injuries to the anterior segment structures. Corneal opacity and amblyopia were the most common causes of poor final visual acuity.

    CONCLUSION: Health education and awareness are essential tools that can prevent avoidable blindness due to traumatic cataract in the paediatric population. The importance of rehabilitation programmes for these patients should be emphasised.
  16. Afifi M
    Singapore Med J, 2006 Jun;47(6):551; author reply 552-3.
    PMID: 16752028
    Comment on: Norsaʼadah B, Rusli BN, Imran AK, Naing L, Winn T. Risk factors of breast cancer in women in Kelantan, Malaysia. Singapore Med J 2005;
    46:698-705
  17. Afroze B, Ngu LH, Roziana A, Aminah M, Noor Shahizan A
    Singapore Med J, 2008 Dec;49(12):e372-4.
    PMID: 19122939
    Supernumerary derivative (22) syndrome is one of the rare genomic syndromes. It is characterised by severe mental retardation, microcephaly, failure to thrive, ear anomalies, preauricular tags or sinus, cleft palate or high arch palate, microganathia, renal anomalies, congenital cardiac defects and genital abnormalities in males. In 99 percent of the cases, one of the parents is a balanced carrier of a translocation between chromosome 11 and chromosome 22. We report the first known case, a female neonate, of supernumerary derivative (22) syndrome from Malaysia.
  18. Ahmad AM
    Singapore Med J, 1995 Dec;36(6):600-5.
    PMID: 8781629
    The purpose of the study is as a preliminary outline of the effectiveness of initiating high-risk individuals into the Health Farm concept in the primary prevention of coronary artery disease (CAD). Thirty-five (35) Army personnel, all male, with risk-factors for CAD were brought together on a Health Farm concept to go through a predesigned ten-day Farm programme comprising CAD risk-assessment, comprehensive medical examination, relevant blood chemistry analysis, physical fitness evaluation, individualised weekly exercise routine, physical fitness workouts, individualised diet, lectures, group discussion and individual counselling. Description of the participants (as measurements of various relevant parameters) are made at the start and as participant-achievement. The results show general participant-compliance to the programme which was reflected by significant changes in weight (p < 0.005), percentile VO2Max (p < 0.005), percentile push-ups (p < 0.005) and girth-difference (p < 0.005). The study showed that the Health Farm concept is effective in initiating high-risk individuals into lifestyles conducive to the primary prevention of CAD. Sustained results towards primary prevention of CAD can be expected with compliance to a long-term follow-up that has been identified and to which participants have been made aware of. Other previous intervention studies are briefly discussed.
  19. Ahmad G, Segasothy M, Morad Z
    Singapore Med J, 1993 Dec;34(6):486-8.
    PMID: 8153706
    The value of urinary erythrocyte morphology in diagnosing glomerular and nonglomerular haematuria was studied using phase contrast microscopy in 105 patients with significant haematuria. Fifty-eight (93.6%) out of 62 patients with glomerulonephritis had dysmorphic erythrocytes and 40 (93.1%) out of the 43 patients with nonglomerular disease had isomorphic erythrocytes in the urine. A mixed picture of glomerular and nonglomerular haematuria was seen in 5 patients. The sensitivity was 93.6%, the specificity was 97.7% and the positive predictive value was 98.3% for glomerulonephritis in patients with dysmorphic haematuria. The positive predictive value for a nonglomerular source of bleeding was 96.7% with isomorphic haematuria. It is concluded that phase contrast microscopic examination of erythrocytes in urine is a simple, inexpensive and noninvasive technique that reliably distinguishes between glomerular and nonglomerular bleeding in patients.
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