MyMedR

Fulltext Clear cell adenocarcinoma of the cervix in a ten-year-old girl without prenatal diethylstilbestrol exposure

Andi Asri AA, Lim BK, Lim YK, A Latiff L

Singapore Med J, 2016 Aug;57(8):470.

PMID: 27549741 DOI: 10.11622/smedj.2016138

Fulltext Characteristics and outcomes of paracetamol poisoning cases at a general hospital in Northern Malaysia

Mohd Zain Z, Fathelrahman AI, Ab Rahman AF

Singapore Med J, 2006 Feb;47(2):134-7.

Paracetamol is available as an over-the-counter medication in many countries including Malaysia. This drug has been implicated in many poisoning cases admitted to hospitals throughout the country.

Functional outcome and quality of life following treatment for post-traumatic osteomyelitis of long bones

Zayzan KR, Yusof NM, Sulong AF, Zakaria Z, Ab Rahman J

Singapore Med J, 2020 Dec 02.

PMID: 33264560 DOI: 10.11622/smedj.2020164

INTRODUCTION: The clinical outcomes and factors associated with treatment failure of post-traumatic osteomyelitis have been investigated by many studies. However, limb functionality and quality of life following treatment for this condition have not been thoroughly studied.

METHODS: This was a cross-sectional study that included 47 patients with post-traumatic osteomyelitis of the lower limb. Functional outcome was assessed using the Lower Extremity Functional Score (LEFS), and quality of life was assessed using the validated Malay version of Short Form-36 version 2.

RESULTS: Mean follow-up time was 4.6 (range 2.3-9.5) years. Median age was 44 years. Osteomyelitis was located in the tibia for 26 patients and in the femur for 21 patients. Osteomyelitis was consequent to internal infection in 38 patients and due to infected open fractures in nine patients. 42 (89.4%) patients had fracture union and control of infection. Bone defect was found to be a significant contributing factor for treatment failure (p = 0.008). The median LEFS for the success group was 65 when compared to 49 for the failure group. Although the success group showed better scores with regard to quality of life, the difference between the two groups was not statistically significant.

CONCLUSION: The success rate for post-traumatic osteomyelitis of the lower limb was high. The presence of a bone defect was associated with treatment failure. Successfully treated patients had significantly better functional outcomes than failed ones.

Fulltext Preoperative physiotherapy and short-term functional outcomes of primary total knee arthroplasty

Mat Eil Ismail MS, Sharifudin MA, Shokri AA, Ab Rahman S

Singapore Med J, 2016 Mar;57(3):138-43.

PMID: 26996450 DOI: 10.11622/smedj.2016055

INTRODUCTION: Physiotherapy is an important part of rehabilitation following arthroplasty, but the impact of preoperative physiotherapy on functional outcomes is still being studied. This randomised controlled trial evaluated the effect of preoperative physiotherapy on the short-term functional outcomes of primary total knee arthroplasty (TKA).
METHODS: 50 patients with primary knee osteoarthritis who underwent unilateral primary TKA were randomised into two groups: the physiotherapy group (n = 24), whose patients performed physical exercises for six weeks immediately prior to surgery, and the nonphysiotherapy group (n = 26). All patients went through a similar physiotherapy regime in the postoperative rehabilitation period. Functional outcome assessment using the algofunctional Knee Injury and Osteoarthritis Outcome Score (KOOS) scale and range of motion (ROM) evaluation was performed preoperatively, and postoperatively at six weeks and three months.
RESULTS: Both groups showed a significant difference in all algofunctional KOOS subscales (p < 0.001). The mean score difference at six weeks and three months was not significant in the sports and recreational activities subscale for both groups (p > 0.05). Significant differences were observed in the time-versus-treatment analysis between groups for the symptoms (p = 0.003) and activities of daily living (p = 0.025) subscales. No significant difference in ROM was found when comparing preoperative measurements and those at three months following surgery, as well as in time-versus-treatment analysis (p = 0.928).
CONCLUSION: Six-week preoperative physiotherapy showed no significant impact on short-term functional outcomes (KOOS subscales) and ROM of the knee following primary TKA.
KEYWORDS: algofunctional Knee Injury and Osteoarthritis Outcome Score; functional outcome; prehabilitation; preoperative physiotherapy; total knee arthroplasty

Fulltext Social and health profiles of rural elderly Malays

Shahar S, Earland J, Abd Rahman S

Singapore Med J, 2001 May;42(5):208-13.

PMID: 11513058

To evaluate the social and health functions of rural elderly Malays.

Fulltext Bronchial thermoplasty for severe asthmatics: a real-world clinical study from Malaysia

Soo CI, Mak WW, Nasaruddin MZ, Ismail R, Ban AY, Abdul Rahaman JA

Singapore Med J, 2024 Feb 01;65(2):119-122.

PMID: 34617697 DOI: 10.11622/smedj.2021144

Fulltext The Mentakab Hypertension Study project. Part I--Complicated hypertensives in hospital: who are they?

Lim TO, Ngah BA, Suppiah A, Ismail F, Abdul Rahman R

Singapore Med J, 1991 Aug;32(4):245-8.

PMID: 1776003

Consecutive hypertensives admitted with cardiovascular complications were studied. One hundred and eight complicated hypertensives (10%) out of 1,066 medical admissions were seen in the three month study. Thirty three per cent had cerebrovascular disease, 30% ischaemic heart disease, 2% had malignant hypertension and 85% had hypertensive heart disease. All patients had uncontrolled hypertension at admission (mean blood pressure 184/115 mmHg). Twenty-four patients (22%) were newly diagnosed; of the rest of previously diagnosed hypertensives (78%), 3% had never been on treatment and 56% had dropped out of treatment, which explained their ineffective blood pressure control. However, 18% of patients had apparently been on regular follow up and treatment, and yet their blood pressure control was poor. Many patients had evidence of renal disease. The prevalence of cardiovascular risk factors was also high; 56% had hypercholesterolaemia; 46% had hypertriglyceridaemia; 44% smoked, 38% were overweight or obese, and 18% were diabetic. This indicates that hypertension is best regarded as an ingredient of a cardiovascular risk profile and its management requires multifactorial correction of all risk factors identified.

Fulltext Mutation analysis of the BRCA1 gene in Malaysian breast cancer patients

Balraj P, Khoo AS, Volpi L, Tan JA, Nair S, Abdullah H

Singapore Med J, 2002 Apr;43(4):194-7.

PMID: 12188064

Thirty patients with early onset breast cancer or familial breast cancer from Malaysia were analysed for germline mutation in the early onset breast cancer I gene (BRCA1). Direct sequencing of the entire coding region of BRCA1 identified a frameshift mutation, c.5447-5448insC (insC5447) (codon 1776 of exon 21) in a patient aged 32 of the Malay ethnic origin, who had no family history of breast and/or ovarian cancer. Eight polymorphisms (2201C > T, 2430T > C, P871L, E1038G, K1183R, 4427T > C, S1613G and IVS8-57delT) were identified in the samples tested.

Fulltext Incidence of thyroid malignancy among goitrous thyroid lesions from the Sarawak General Hospital 2000-2004

Htwe TT, Hamdi MM, Swethadri GK, Wong JO, Soe MM, Abdullah MS

Singapore Med J, 2009 Jul;50(7):724-8.

PMID: 19644631

Thyroid cancer is the most common among all endocrine malignancies. The worldwide prevalence of goitre in the general population is estimated at 4-7 percent and the incidence of malignancy in goitrous thyroid is about ten percent. It is postulated that goitrous thyroid is a precursor lesion to the development of malignant thyroid diseases. As Sarawak is a state well known for endemic goitre, this study focused on establishing the incidence of thyroid malignancy among goitrous thyroid swellings.

Fulltext Expression of Galectin-3 and Galectin-7 in thyroid malignancy as potential diagnostic indicators

Than TH, Swethadri GK, Wong J, Ahmad T, Jamil D, Maganlal RK, et al.

Singapore Med J, 2008 Apr;49(4):333-8.

PMID: 18418527

It has been suggested that Galectin-3 (Gal-3) and Galectin-7 (Gal-7) are potential tumour markers for differentiating thyroid carcinoma from its benign counter part. Galectins are beta-galactoside-binding proteins with Gal-3 being a redundant pre-mRNA splicing factor. They are supposed to be p53-related regulators in cell growth and apoptosis, being either anti-apoptotic or pro-apoptotic. Although the value of Gal-3 has been studied extensively, there is little knowledge regarding the expression of Gal-7 in thyroid malignancy.

Fulltext A comparison of commonly used anti-emetics for the prevention of emetic sequelae after a major gynaecological surgery

Sharma S, Abdullah N

Singapore Med J, 2000 Apr;41(4):147-50.

PMID: 11063177

Prospective, randomized, double-blind, placebo-controlled study involving one hundred ASA I-II patients undergoing major gynaecological surgery.

Fulltext Knowledge, confidence and attitude of primary care doctors in managing in-flight medical emergencies: a cross-sectional survey

Ng WL, Abdullah N

Singapore Med J, 2020 Feb;61(2):81-85.

PMID: 32152640 DOI: 10.11622/smedj.2020016

INTRODUCTION: Medical emergencies occur at a rate of one in 604‒753 flights. Doctors travelling on commercial flights may encounter an in-flight medical emergency requiring their assistance. There is a paucity of studies on how confident primary care doctors are in managing in-flight medical emergencies. This study aimed to determine the knowledge, confidence and attitude of primary care doctors in managing in-flight medical emergencies.

METHODS: A cross-sectional study was conducted on all primary care doctors working in government health clinics in Kuala Lumpur, Malaysia, from October 2016 to November 2016. A self-reported questionnaire was used, which included questions on demographic information, knowledge of in-flight medicine, and the attitude and confidence of primary care doctors in managing in-flight medical emergencies.

RESULTS: 182 doctors completed the questionnaire (92.9% response rate). The mean knowledge score was 8.9 out of a maximum score of 20. Only 11.5% of doctors felt confident managing in-flight medical emergencies. The majority (69.2%) would assist in an in-flight medical emergency, but the readiness to assist was reduced if someone else was already helping or if they were not familiar with the emergency. Total knowledge score was positively associated with confidence in managing in-flight medical emergencies (p = 0.03).

CONCLUSION: Only one in ten primary care doctors in this study felt confident managing in-flight medical emergencies. A higher total knowledge score of in-flight medical emergencies was positively associated with greater confidence in managing them. Educational programmes to address this gap in knowledge may be useful to improve doctors' confidence in managing in-flight medical emergencies.

Fulltext Genomic species identification of Acinetobacter of clinical isolates by 16S rDNA sequencing

Misbah S, Hassan H, Yusof MY, Hanifah YA, AbuBakar S

Singapore Med J, 2005 Sep;46(9):461-4.

PMID: 16123830

This study aims to identify Acinetobacter of clinical isolates from the University of Malaya Medical Centre (UMMC), Kuala Lumpur, to the species level by 16S rDNA sequencing.

Fulltext Is there a role for the obstetric flying squad in Peninsula Malaysia?

Monga D, Achanna S

Singapore Med J, 1999 Feb;40(2):78-80.

PMID: 10414162

The Obstetric Flying Squad (OFS) has been operating in Peninsular Malaysia for over three decades. In the light of current controversies regarding its role in modern day obstetric practice, its status in Malaysia over the last 12 years is reviewed.

Fulltext Toxic epidermal necrolysis in Malaysian adults. A retrospective study

Ting HC, Adam BA

Singapore Med J, 1985 Oct;26(6):456-9.

PMID: 2937150

We report a retrospective study of all cases of toxic epidermal necrolysis admitted to the adult medical wards of the University Hospital in Kuala Lumpur over a 16 year period from 1967 to 1983. Over this period of time only 7 cases were encountered, suggesting the condition is rare in adults in our country. All the cases were females and the age ranged from 21 to 41 years. Four cases were due to drugs, 2 were idiopathic and one was attributed to Staphylococcal infection. One patient died. The other patients recovered completely with no sequelae.

Fulltext A profile of cancer patient outcomes from a tertiary care teaching hospital in Malaysia

Suthahar A, Gurpreet K, Ambigga D, Maniam T, Dhachayani S, Fuad I, et al.

Singapore Med J, 2009 Jul;50(7):720-3.

PMID: 19644630

The aim of this paper was to determine the sociodemographic and cancer characteristics of patients with cancer at a tertiary care centre.

Fulltext Risk factors of breast cancer in women in Kelantan, Malaysia

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

Fulltext The health farm concept in the primary prevention of coronary artery disease

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.

Fulltext Prevalence of depression among women attending a primary urban care clinic in Malaysia

Mohd Sidik S, Arroll B, Goodyear-Smith F, Ahmad R

Singapore Med J, 2012 Jul;53(7):468-73.

PMID: 22815016

Depression affects more women than men in Malaysia. The objective of this paper was to determine the prevalence of depression and its associated factors among women attending a government primary care clinic.

Fulltext Fibreoptic bronchoscopy--a Malaysian experience

Yaacob I, Harun Z, Ahmad Z

Singapore Med J, 1991 Feb;32(1):26-8.

PMID: 2017700

Two hundred and ninety-three bronchoscopies were done for 285 patients (78% males, 22% females) at Hospital University Sains Malaysia between 1984 and 1988. The mean age was 56.4 years (range 13 to 90 years). 70.2% of patients underwent bronchoscopies to confirm or exclude the diagnosis of carcinoma of the bronchus, out of which 58% were confirmed to have bronchial carcinoma. 77% of the 98 patients with visible endobronchial tumours had biopsy specimens diagnostic of malignancy. Brushing and washing cytology increased the positive yield to 92%. The commonest histological type of bronchial carcinoma identified was squamous cell carcinoma (48.1%), followed by small cell carcinoma (27.1%), anaplastic/undifferentiated carcinoma (12.9%), adenocarcinoma (9.4%) and large cell carcinoma (2.4%). Bronchoscopy for the investigation of haemoptysis identified the commonest cause as 'bronchitis'. There were no complications noted in our series. Notable differences of our experience compared to that of the western series were the high percentage of bronchoscopy done for infective respiratory disorders and the younger age of our patients.

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