Displaying publications 1 - 20 of 47 in total

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  1. Fulltext Acute Acalculous Cholecystitis after Laparoscopic Appendicectomy that Responded to Conservative Management
    Hui CK
    Malays J Med Sci, 2011 Jan;18(1):76-8.
    PMID: 22135578
    Inflammation of the gallbladder without evidence of calculi is known as acute acalculous cholecystitis (AAC). AAC is frequently associated with a poor prognosis and a high mortality rate. Thus, early diagnosis and prompt surgical intervention has been recommended to improve the outcome of AAC. Herein, I present a case report of AAC complicating laparoscopic appendicectomy. Unlike previous studies that have reported the need for urgent intervention in patients with AAC, in this study, our patient responded to conservative management. Therefore, the management of AAC after laparoscopic appendicectomy should be individualised.
    Matched MeSH terms: Conservative Treatment
  2. Fulltext Percutaneous t2 and t3 radiofrequency sympathectomy for complex regional pain syndrome secondary to brachial plexus injury: a case series
    Chen CK, Phui VE, Nizar AJ, Yeo SN
    Korean J Pain, 2013 Oct;26(4):401-5.
    PMID: 24156009 DOI: 10.3344/kjp.2013.26.4.401
    Complex regional pain syndrome secondary to brachial plexus injury is often severe, debilitating and difficult to manage. Percuteneous radiofrequency sympathectomy is a relatively new technique, which has shown promising results in various chronic pain disorders. We present four consecutive patients with complex regional pain syndrome secondary to brachial plexus injury for more than 6 months duration, who had undergone percutaneous T2 and T3 radiofrequency sympathectomy after a diagnostic block. All four patients experienced minimal pain relief with conservative treatment and stellate ganglion blockade. An acceptable 6 month pain relief was achieved in all 4 patients where pain score remained less than 50% than that of initial score and all oral analgesics were able to be tapered down. There were no complications attributed to this procedure were reported. From this case series, percutaneous T2 and T3 radiofrequency sympathectomy might play a significant role in multi-modal approach of CRPS management.
    Matched MeSH terms: Conservative Treatment
  3. A simple, safe, and effective surgical technique for the treatment of post-traumatic parotid sialocoele
    Asha'ari ZA, Razali MS, Leman WI, Ahmad A
    Malays J Med Sci, 2014 Jan;21(1):72-4.
    PMID: 24639617
    Post-traumatic parotid sialocoele is a subcutaneous extravasation of saliva from the parotid gland secondary to traumatic disruption of its duct or parenchyma. Currently, there is no consensus regarding the best therapy for parotid sialocoele, as it is resistant to conservative management. The present paper puts forward a relatively simple, safe and effective technique for the treatment of parotid sialocoele, specifically a peroral drainage technique. The results justify our recommendation to use this approach for the treatment of sialocoele.
    Matched MeSH terms: Conservative Treatment
  4. Fulltext Arthroscopic resection of the distal clavicle with concomitant subacromial decompression: a case series
    Chan H, Ooi C, Lim M, Ong E, Zulkiflee O
    Malays Orthop J, 2014 Jul;8(2):59-62.
    PMID: 25279097 MyJurnal DOI: 10.5704/MOJ.1407.007
    Shoulder impingement syndrome and acromioclavicular joint osteoarthritis often occur simultaneously and easily missed. Kay et al. reported excellent results with combined arthroscopic subacromial decompression and resection of the distal end of the clavicle in patients with both disorders(1). Arthroscopic treatment of these disorders produces more favourable results than open procedures. We report two patients who were not responding to conservative management and were treated with direct arthroscopic distal clavicle excision and subacromial decompression in single setting. Both patients gained good postoperative outcome in terms of pain score, function and strength improvement assessed objectively with visual analogue score (VAS) and University of California Los Angeles Score (UCLA).
    Matched MeSH terms: Conservative Treatment
  5. Fulltext Iatrogenic submandibular duct rupture complicating sialography: a case report
    Sharouny H, Omar RB
    Iran Red Crescent Med J, 2014 Sep;16(9):e7882.
    PMID: 25593739 DOI: 10.5812/ircmj.7882
    INTRODUCTION: Sialolithiasis is the most common disease of salivary glands. Sialography is particularly important for the assessment of the outflow tract and in diagnosing obstructive salivary gland lesions including calculi.

    CASE PRESENTATION: We report on a 38-year-old female with sialolithiasis whom had Wharton's duct perforation, complicating the sialography. She was treated conservatively with a course of co-amoxiclav, oral prednisolone for three days and pain-killers. The patient was clinically well on follow-up reassessments at the end of the first week and three weeks post procedure.

    CONCLUSIONS: Perforation of salivary duct complicating the sialography is rare. Awareness of this potential complication and utilizing a good sialography technique need to be advocated amongst radiologists. Response to treatment by conservative management is preferred as illustrated in this case.

    Matched MeSH terms: Conservative Treatment
  6. Fulltext Nutritional management of enterocutaneous fistula: a retrospective study at a Malaysian university medical center
    Badrasawi MM, Shahar S, Sagap I
    J Multidiscip Healthc, 2014;7:365-70.
    PMID: 25187726 DOI: 10.2147/JMDH.S58752
    Enterocutaneous fistula is a challenging clinical condition with serious complications and considerable morbidity and mortality. Early nutritional support has been found to decrease these complications and to improve the clinical outcome. Location of the fistula and physiological status affect the nutrition management plan in terms of feeding route, calories, and protein requirements. This study investigated the nutritional management procedures at the Universiti Kebangsaan Malaysia Medical Center, and attempted to determine factors that affect the clinical outcome. Nutritional management was evaluated retrospectively in 22 patients with enterocutaneous fistula seen over a 5-year period. Medical records were reviewed to obtain data on nutritional status, biochemical indices, and route and tolerance of feeding. Calories and protein requirements are reported and categorized. The results show that surgery was the predominant etiology and low output fistula was the major physiological category; anatomically, the majority were ileocutaneous. The spontaneous healing rate was 14%, the total healing rate was 45%, and the mortality rate was 22%, with 14% due to fistula-associated complications. There was a significant relationship between body mass index/serum albumin levels and fistula healing; these parameters also had a significant relationship with mortality. Glutamine was used in 50% of cases; however, there was no significant relationship with fistula healing or mortality rate. The nutritional status of the patient has an important impact on the clinical outcome. Conservative management that includes nutrition support is very important in order to improve nutritional status before surgical repair of the fistula.
    Matched MeSH terms: Conservative Treatment
  7. Fulltext Synovial Cyst: A Culprit for Recalcitrant Iliotibial Band Syndrome: A Case Report
    Yeoh C, Lim G, Sathappan SS
    Malays Orthop J, 2015 Nov;9(3):68-70.
    PMID: 28611916 DOI: 10.5704/MOJ.1511.011
    We present the case of a 56-year old gentleman who presented with recalcitrant iliotibial band (ITB) friction syndrome which did not improve with various modalities of conservative treatment. Magnetic Resonance Imaging (MRI) of the affected knee did not show pathology typical of ITB friction syndrome. However, open exploration revealed a synovial cyst deep to the iliotibial band, abutting against the anterolateral capsule. The presence of distinctive clinical signs on physical examination should alert clinicians to consider knee synovial cyst as a differential diagnosis when dealing with recalcitrant ITB syndrome.
    Matched MeSH terms: Conservative Treatment
  8. Fulltext Spontaneous resolution of asymptomatic hepatic pseudoaneurysm post radiofrequency ablation
    Ch'ng LS, Tazuddin EEM, Young B, Ali AFM
    BJR Case Rep, 2016;2(2):20150306.
    PMID: 30363592 DOI: 10.1259/bjrcr.20150306
    Radiofrequency ablation (RFA) of a hepatic tumour is an established treatment option with an acceptable complication rate. Formation of a pseudoaneurysm after RFA of liver metastasis is an uncommon complication. We report the case of a 69-year-old female patient developing a hepatic pseudoaneurysm after RFA of liver metastasis. On a follow-up CT scan 6 weeks later, there was spontaneous resolution of the pseudoaneurysm. Hepatic pseudoaneurysms are usually treated owing to the risk of rupture. Invasive procedures or conservative management of an asymptomatic hepatic pseudoaneurysm is still the subject of debate. The spontaneous resolution of a hepatic pseudoaneurysm in our patient suggests that an asymptomatic pseudoaneurysm maybe observed for resolution instead of being treated at presentation.
    Matched MeSH terms: Conservative Treatment
  9. Fulltext Reiter's syndrome postintravesical Bacillus Calmette-Guérin instillations
    Ng KL, Chua CB
    Asian J Surg, 2017 Apr;40(2):163-165.
    PMID: 25183290 DOI: 10.1016/j.asjsur.2014.01.016
    Intravesical Bacillus Calmette-Guérin (BCG) has been a proven and effective immunotherapy treatment for superficial transitional cell carcinoma (TCC) of the bladder, especially for high-grade tumors and carcinoma in situ. Nevertheless, significant side effects are associated with BCG instillations, including fever, myalgia, malaise, dysuria, hematuria, and irritable lower urinary tract symptoms. We herein report the case of a patient who developed Reiter's syndrome following intravesical BCG instillations. A 39-year-old Chinese man presented with a 3-week history of dysuria, suprapubic pain, and pain at the tip of the penis postmicturition. Initial investigations revealed that he had microhematuria, and an ultrasound with computed tomography scan of the abdomen showed a bladder mass. Transurethral resection of the bladder tumor was performed and the patient received a single dose of intravesical mitomycin postoperatively. Results of histopathological examination revealed high-grade bladder TCC (G3pT1), and the patient was managed with intravesical BCG for 2 weeks following the surgery. Four weekly cycles of BCG were administered uneventfully; however, before the fifth instillation, the patient complained of urethral discharge, bilateral conjunctivitis, and low back pain. Reiter's syndrome was diagnosed as a rare but known complication of BCG instillation and the BCG immunotherapy was withheld. The patient was treated with nonsteroidal antiinflammatory drugs (for back pain) and eye ointment (for conjunctivitis) and his condition improved. This case report of Reiter's syndrome should be highlighted as a rare but significant complication of BCG immunotherapy and urologists should have a high index of suspicion to diagnose this rare complication.
    Matched MeSH terms: Conservative Treatment
  10. Facial carbuncle - a new method of conservative surgical management plus irrigation with antibiotic-containing solution
    Ngui LX, Wong LS, Shashi G, Abu Bakar MN
    J Laryngol Otol, 2017 Sep;131(9):830-833.
    PMID: 28412984 DOI: 10.1017/S0022215117000834
    OBJECTIVE: This paper reports on a non-conventional method for the management of facial carbuncles, highlighting its superiority over conventional surgical treatment in terms of cosmetic outcome and shorter duration of wound healing.

    BACKGROUND: The mainstay of treatment for carbuncles involves the early administration of antibiotics in combination with surgical intervention. The conventional saucerisation, or incision and drainage, under normal circumstances results in moderate to large wounds, which may need secondary surgery such as skin grafting, resulting in a longer duration of wound healing and jeopardising cosmetic outcome.

    CASE REPORTS: The reported three cases presented with extensive carbuncles over the chin, face and lips region. In addition to early commencement of intravenous antibiotics, the pus was drained, with minimal incision and conservative wound debridement, with the aim of maximal skin conservation. This was followed by thrice-daily irrigation with antibiotic-containing solution for a minimum of 2 consecutive days. The wounds healed within two to four weeks, without major cosmetic compromise.

    CONCLUSION: The new method showed superior cosmetic outcomes, with a shorter duration of wound healing. Conservative surgical management can be performed under regional anaesthesia, which may reduce morbidity and mortality; patients with facial carbuncles often have higher risks with general anaesthesia.

    Matched MeSH terms: Conservative Treatment
  11. Fulltext Facial subcutaneous emphysema as a rare complication of tonsillectomy
    Mark Paul, Najihah Hanim Asmi, Rohaida Ibrahim, Eshamsol Kamar Omar, Irfan Mohamad
    International Medical Journal Malaysia, 2017;16(2):121-124.
    MyJurnal
    Tonsillectomy is a very common procedure in Otolaryngology practice. Common complications include
    bleeding, which can be primary or secondary due to infection of the tonsillar bed. Subcutaneous emphysema
    after a tonsillectomy is very rare. We report a 19-year-old girl who developed cervicofacial subcutaneous
    emphysema several hours after tonsillectomy with successful conservative treatment outcome.
    Matched MeSH terms: Conservative Treatment
  12. Fulltext Pain intervention for Trigeminal Neuralgia
    Hadi, M.A., Nor Zamzila, A., Rasydan, A.G.M., Suhaila, N., Nizamuddin, I.M.
    International Medical Journal Malaysia, 2017;16(11):53-53.
    MyJurnal
    In the management of chronic pain, stepwise oral analgesics of graded strength are
    considered as first-line therapy. Minimally invasive interventional procedures remain an
    option for its treatment when pharmacological therapy fails to control the pain. We
    reported three classical cases of chronic trigeminal neuralgia that were managed with
    two types of pain intervention approaches after failing conservative management. (Copied from article).
    Matched MeSH terms: Conservative Treatment
  13. Fulltext Pulled/nursemaid's elbow
    Mohd Miswan MF, Othman MS, Muhamad Effendi F, Ibrahim MI, Rozali KN
    Malays Fam Physician, 2017;12(1):26-28.
    PMID: 28503271
    Nursemaid's elbow is a radial head subluxation caused by axial traction on the extended arm while the forearm is pronated, allowing for slippage of the radial head. A 2-year-old boy presented with pain, swelling and reduced range of movement of the right elbow for 4 days. The mother noted that the child was moving the right upper limb less often and there was tenderness over the right elbow. X-ray of the right elbow showed subluxation of the elbow joint with no obvious fracture. A trial of conservative management was decided upon and the patient was placed on a right elbow backslab with the right forearm in a supine position. On follow-up, there was no swelling, tenderness or neurological deficit noted. A repeate x-ray revealed normal findings.
    Matched MeSH terms: Conservative Treatment
  14. Fulltext Pulled/nursemaid’s elbow
    Mohd Miswan M. F., Mohamad Saifudin Othman, Ferdhany Muhamad Effendi, Khairul Nizam Rozali, Mohd Ikraam Ibrahim
    Malays Fam Physician, 2017;12(1):26-28.
    MyJurnal
    Nursemaid’s elbow is a radial head subluxation caused by axial traction on the extended arm while
    the forearm is pronated, allowing for slippage of the radial head. A 2-year-old boy presented with
    pain, swelling and reduced range of movement of the right elbow for 4 days. The mother noted that
    the child was moving the right upper limb less often and there was tenderness over the right elbow.
    X-ray of the right elbow showed subluxation of the elbow joint with no obvious fracture. A trial of
    conservative management was decided upon and the patient was placed on a right elbow backslab
    with the right forearm in a supine position. On follow-up, there was no swelling, tenderness or
    neurological deficit noted. A repeate x-ray revealed normal findings.
    Matched MeSH terms: Conservative Treatment
  15. Tokyo Guidelines 2018: management bundles for acute cholangitis and cholecystitis
    Mayumi T, Okamoto K, Takada T, Strasberg SM, Solomkin JS, Schlossberg D, et al.
    J Hepatobiliary Pancreat Sci, 2018 Jan;25(1):96-100.
    PMID: 29090868 DOI: 10.1002/jhbp.519
    Management bundles that define items or procedures strongly recommended in clinical practice have been used in many guidelines in recent years. Application of these bundles facilitates the adaptation of guidelines and helps improve the prognosis of target diseases. In Tokyo Guidelines 2013 (TG13), we proposed management bundles for acute cholangitis and cholecystitis. Here, in Tokyo Guidelines 2018 (TG18), we redefine the management bundles for acute cholangitis and cholecystitis. Critical parts of the bundles in TG18 include the diagnostic process, severity assessment, transfer of patients if necessary, and therapeutic approach at each time point. Observance of these items and procedures should improve the prognosis of acute cholangitis and cholecystitis. Studies are now needed to evaluate the dissemination of these TG18 bundles and their effectiveness. Free full articles and mobile app of TG18 are available at: http://www.jshbps.jp/modules/en/index.php?content_id=47. Related clinical questions and references are also included.
    Matched MeSH terms: Conservative Treatment
  16. Fulltext Multiple Scattered and Small Lesions of Lower Limbs: Idiopathic Calcinosis Cutis: A Case Report
    Ferdaus-Kamudin NA, Mohamed-Haflah NH
    Malays Orthop J, 2018 Mar;12(1):66-68.
    PMID: 29725520 MyJurnal DOI: 10.5704/MOJ.1803.008
    Calcinosis cutis is a rare presentation and not many cases have been reported especially of idiopathic type. We are reporting a case of idiopathic calcinosis cutis of lower limbs in a 33-year old female who presented to our clinic for multiple painless swellings over her lower limbs for the past six months, without any history of trauma or infection. We have decided to observe her condition on regular follow-up and conservative management.
    Matched MeSH terms: Conservative Treatment
  17. Case 263
    Martin JL, Vlachou PA
    Radiology, 2018 11;289(2):568-571.
    PMID: 30332363 DOI: 10.1148/radiol.2018162112
    History A 58-year-old woman was seen in the rheumatology clinic for bilateral wrist and knee pain that was unresponsive to physiotherapy and intra-articular steroid injections. Remote fracture of the left tibia from a motor vehicle collision was reported and was previously treated with conservative management. Serologic work-up for inflammatory disease was negative. The patient reported no prior surgical or medical history. Social history revealed remote immigration from Malaysia. Radiographs of the hands and knees were obtained ( Figs 1 - 4 ). [Figure: see text][Figure: see text][Figure: see text][Figure: see text].
    Matched MeSH terms: Conservative Treatment
  18. Fulltext Conservative Management of Dental Erosion in Adolescents with Medical Conditions
    Mohd Nor H, Harun NA
    Case Rep Dent, 2018;2018:3230983.
    PMID: 30647975 DOI: 10.1155/2018/3230983
    The prevalence of dental erosion among children and adolescents is trending higher in recent decades and is becoming a major concern. Dental erosion can be caused by either extrinsic or intrinsic acids or both. One of the established aetiological factors for dental erosion by intrinsic acid is the gastrooesophageal reflux disease. The degree of dental erosions may be influenced by any medical conditions that cause a reduction in salivary flow such as the salivary gland excision, autoimmune disease, radiation to the head and neck regions, and medications. If left untreated, the dental erosion can cause dentine hypersensitivity, loss of occlusal vertical height, and aesthetic problems. For effective management of dental erosion, the aetiology of each case must be determined, and its detection at an early stage is of prime importance. This case report illustrates the conservative management of dental erosion in two adolescent patients presented with their medical conditions and behaviour issues. The aim of the treatments was to preserve the vitality of the affected teeth. The treatments were successfully completed using a conservative approach, with the patients' medical conditions taken into consideration.
    Matched MeSH terms: Conservative Treatment
  19. Fulltext Early functional and radiological outcomes between plaster cast and fiberglass cast in stable thoracolumbar burst fracture
    Zamzuri Z., Ariff M.S., Mohd Fairuz Ad., Mohd Shukrimi A., Nazri My.
    International Medical Journal Malaysia, 2018;17(1):121-126.
    MyJurnal
    Introduction: Burst fracture results from compression failure of both the anterior and middle columns under
    substantial axial loads. Conservative treatment was a method of treatment for fractures without
    neurological deficit. This cross sectional study was designed to evaluate the functional and radiological
    outcome of patient with thoracolumbar burst fracture treated conservatively. Methods: 40 cases were
    recruited from January 2013 till December 2015. They were followed-up with minimum period of 1 year and
    evaluated for the functional (Oswetry Disbility Index) and radiological outcomes (kyphotic angle deformity
    and anterior body compression). Results: 20 patients were treated with body cast made form plaster of
    Paris and remaining 20 patients with fiberglass cast. In plaster of Paris group, mean kyphotic angle
    deformity at last follow up was 16.60 ± 2.95 with a mean improvement 4.45 degree and anterior body
    compression at last follow up was 30.35% ± 10.2 with mean improvement of 9.30%. In fiberglass group, mean
    kyphotic angle deformity at last follow up was 15.55 ± 3.38 with a mean improvement 7.25 degree and
    anterior body compression at last follow up was 25.90% ± 7.81 with mean improvement of 3.45%. The
    functional outcome showed Oswetry Disability Index (ODI) score in plaster of Paris group was 23.70 (SD =
    7.82) and in fiberglass group was 18.50 (SD = 5.94). Conclusions: Application of body cast using a fiberglass
    material give better radiological outcome hence less pain, more functional and higher patient’s satisfaction
    as compared to plaster of Paris.
    Matched MeSH terms: Conservative Treatment
  20. Fulltext Coughing on palpation: a rare complication of vagal schwannoma
    Samarakkody, Z.M., Sayuti, K.A., Mat Zin, A.A., Wan Abdul Wahab, W.N.N., Mohamad, I.
    Malaysian Family Physician, 2018;13(3):40-43.
    MyJurnal
    Cervical vagal schwannoma is an uncommon, benign neoplasm. It is usually asymptomatic and
    presents as a painless, palpable mass in the neck. However, large schwannomas can cause dysphagia,
    dysphonia or dyspnea as a result of compression. We report a case of an extremely rare complication
    of vagal schwannoma in which neck palpation induced the patient to cough. As the patient refused
    any surgical intervention, conservative management was used.
    Matched MeSH terms: Conservative Treatment
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