Displaying publications 1 - 20 of 208 in total

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  1. Khor KH, Shiels IA, Campbell FE, Greer RM, Rose A, Mills PC
    Vet J, 2014 Feb;199(2):229-35.
    PMID: 24321367 DOI: 10.1016/j.tvjl.2013.11.006
    Analysis of heart rate (HR) and heart rate variability (HRV) are powerful tools to investigate cardiac diseases, but current methods, including 24-h Holter monitoring, can be cumbersome and may be compromised by movement artefact. A commercially available data capture and analysis system was used in anaesthetised healthy cats to measure HR and HRV during pharmacological manipulation of HR. Seven healthy cats were subjected to a randomised crossover study design with a 7 day washout period between two treatment groups, placebo and atenolol (1mg/kg, IV), with the efficacy of atenolol to inhibit β1 adrenoreceptors challenged by epinephrine. Statistical significance for the epinephrine challenge was set at P<0.0027 (Holm-Bonferroni correction), whereas a level of significance of P<0.05 was set for other variables. Analysis of the continuous electrocardiography (ECG) recordings showed that epinephrine challenge increased HR in the placebo group (P=0.0003) but not in the atenolol group. The change in HR was greater in the placebo group than in the atenolol group (P=0.0004). Therefore, compared to cats pre-treated with placebo, pre-treatment with atenolol significantly antagonised the tachycardia while not significantly affecting HRV. The increased HR in the placebo group following epinephrine challenge was consistent with a shift of the sympathovagal balance towards a predominantly sympathetic tone. However, the small (but not significant at the critical value) decrease in the normalised high-frequency component (HFnorm) in both groups of cats suggested that epinephrine induced a parasympathetic withdrawal in addition to sympathetic enhancement (increased normalised low frequency component or LFnorm). In conclusion, this model is a highly sensitive and repeatable model to investigate HRV in anaesthetised cats that would be useful in the laboratory setting for short-term investigation of cardiovascular disease and subtle responses to pharmacological agents in this species.
    Matched MeSH terms: Electrocardiography/veterinary
  2. Ohn MH, Souza U, Ohn KM
    Tzu Chi Med J, 2020 08 02;32(4):392-397.
    PMID: 33163387 DOI: 10.4103/tcmj.tcmj_91_19
    Objective: Negative affect state toward learning has a substantial impact on the learning process, academic performance, and practice of a particular subject, but such attitude toward electrocardiogram (ECG) learning has still received relatively little attention in medical education research. In spite of the significant emphasis in investigating ECG teaching method, the educators would not be able to address ECG incompetency without understanding the negative perception and attitude toward ECG learning. The purpose of this study was to assess the undergraduate students' difficulties in ECG learning and hence help educators design appropriate ECG learning curriculum to instill competent skill in ECG interpretation based on this outcome.

    Materials and Methods: A total of 324 undergraduate preclinical (year 2) and clinical (year 3-5) medical students participated in this study. The research design used thematic analysis of an open-ended questionnaire to analyze the qualitative data.

    Results: The thematic analysis detected five major emergent themes: lack of remembering (18.2%), lack of understanding (28.4%), difficulty in applying (3.6%), difficulty in analysis (15.1%), and difficulty in interpretation (17.8%), of which addressing these challenges could be taken as a foundation step upon which medical educators put an emphasis on in order to improve ECG teaching and learning.

    Conclusion: Negative attitude toward ECG learning poses a serious threat to acquire competency in ECG interpretation skill. The concept of student's memorizing ECG is not a correct approach; instead, understanding the concept and vector analysis is an elementary key for mastering ECG interpretation skill. The finding of this study sheds light into a better understanding of medical students' deficient points of ECG learning in parallel with taxonomy of cognitive domain and enables the medical teachers to come up with effective and innovative strategies for innovative ECG learning in an undergraduate medical curriculum.

    Matched MeSH terms: Electrocardiography
  3. Salari N, Shohaimi S, Najafi F, Nallappan M, Karishnarajah I
    Theor Biol Med Model, 2013 Sep 18;10:57.
    PMID: 24044669 DOI: 10.1186/1742-4682-10-57
    OBJECTIVE: The classification of Acute Coronary Syndrome (ACS), using artificial intelligence (AI), has recently drawn the attention of the medical researchers. Using this approach, patients with myocardial infarction can be differentiated from those with unstable angina. The present study aims to develop an integrated model, based on the feature selection and classification, for the automatic classification of ACS.

    METHODS: A dataset containing medical records of 809 patients suspected to suffer from ACS was used. For each subject, 266 clinical factors were collected. At first, a feature selection was performed based on interviews with 20 cardiologists; thereby 40 seminal features for classifying ACS were selected. Next, a feature selection algorithm was also applied to detect a subset of the features with the best classification accuracy. As a result, the feature numbers considerably reduced to only seven. Lastly, based on the seven selected features, eight various common pattern recognition tools for classification of ACS were used.

    RESULTS: The performance of the aforementioned classifiers was compared based on their accuracy computed from their confusion matrices. Among these methods, the multi-layer perceptron showed the best performance with the 83.2% accuracy.

    CONCLUSION: The results reveal that an integrated AI-based feature selection and classification approach is an effective method for the early and accurate classification of ACS and ultimately a timely diagnosis and treatment of this disease.

    Matched MeSH terms: Electrocardiography
  4. Ng CF, Tiau PW, Tan HJ, Norlinah MI
    J R Coll Physicians Edinb, 2019 Mar;49(1):37-39.
    PMID: 30838990 DOI: 10.4997/JRCPE.2019.108
    Levodopa is the most effective medical treatment for Parkinson's disease (PD) to date. As dopamine is known to increase cardiac inotropism and vasomotor tone, peripheral dopamine decarboxylase inhibitor is coadministered to suppress the peripheral conversion of levodopa to dopamine. Levodopa poses potential cardiovascular risks, thus its use in patients with existing coronary artery disease needs to be carefully monitored. We report a case of an elderly male with newly diagnosed PD who developed non-ST-elevation myocardial infarction following levodopa (Madopar) initiation.
    Matched MeSH terms: Electrocardiography
  5. Azarisman SM, Magdi YA, Noorfaizan S, Oteh M
    N Engl J Med, 2007 Nov 1;357(18):1873-4.
    PMID: 17978302 DOI: 10.1056/NEJMc070990
    Matched MeSH terms: Electrocardiography
  6. Loh KY, Mohamed AL
    N Engl J Med, 2005 Sep 1;353(9):933.
    PMID: 16135838 DOI: 10.1056/NEJMicm040398
    Matched MeSH terms: Electrocardiography*
  7. Dharmalingam TK, Nor Azian AZ, Thiruselvi S, Abdul Aziz J
    Med J Malaysia, 2013 Apr;68(2):177-8.
    PMID: 23629572
    Left bundle branch block (LBBB) during anaesthesia is uncommon. During general anaesthesia, LBBB may be related to hypertension or tachycardia and its acute onset makes the diagnosis of acute myocardial ischemia or infarction difficult. We would like to present a case report of a healthy patient who developed LBBB intra operatively. Acute LBBB should lead to suspicion of acute coronary syndrome until proven otherwise. Inability to exclude an acute cardiac event resulted in postponement of surgery twice after general anaesthesia was administered. Cardiological investigation of our patient showed physiological left ventricular hypertrophy (LVH), "athlete's heart" which was the most likely cause of the LBBB under anaesthesia.
    Matched MeSH terms: Electrocardiography
  8. Lim AL, Lam HY, Kareem BA, Kamarulzaman MH
    Med J Malaysia, 2012 Apr;67(2):219-21.
    PMID: 22822650 MyJurnal
    Kawasaki disease is primarily a condition that affects young children and it is associated with cardiac morbidity and mortality. This disease has been known to cause coronary artery aneurysms which occurs as a sequelae of vasculitis. The progression of triple vessel disease in adult which results from cardiac complications from Kawasaki disease is rare. We report a case of a young man with history of Kawasaki disease at infancy presenting with triple vessel disease requiring cardiac bypass surgery at the age of 20 years old.
    Matched MeSH terms: Electrocardiography
  9. Liew CK, Leong WS
    Med J Malaysia, 2012 Feb;67(1):108-10.
    PMID: 22582559 MyJurnal
    Coronary arteries vasospasm (CAS) is commonly seen in invasive cardiology laboratory during diagnostic catheterization or coronary intervention. Though the incidence of Printzmetal angina is uncommon, coronary vasospasm resulting in acute myocardial infarct is rare, especially if there is no significant atherosclerotic plaque within the coronary vasculature.
    Matched MeSH terms: Electrocardiography
  10. Sacco A, Morici N, Belli O, Bossi I, Mafrici A, Klugmann S
    Med J Malaysia, 2011 Dec;66(5):520-1.
    PMID: 22390119
    We present a case of "inverted Tako-Tsubo" syndrome in a woman sedated with meperidine before undergoing a colonscopy. We discuss possible etiology of this ventricular dysfunction.
    Matched MeSH terms: Electrocardiography
  11. Murali A, Balu K, Paari V, Rajendiran G
    Med J Malaysia, 2011 Dec;66(5):499-500.
    PMID: 22390111
    A 38 year old gentleman presented with fever and right hypochondrial pain. On further evaluation he was detected to have an amoebic liver abscess (ALA) in the right lobe of the liver. The abscess yielded anchovy sauce pus on percutaneous drainage. Following the percutaneous drainage the patient developed tachycardia. Electrocardiogram revealed atrial flutter with rapid ventricular rate and ST elevation in all leads suggestive of pericarditis. The atrial flutter was reverted to sinus rhythm by cardioversion. The patient then had an uncomplicated convalescence. Amoebic pericarditis, though rare, is a serious complication of amoebic liver abscess. Pericardial complications are usually seen with left lobe liver abscess due to its proximity. Both pericarditis and cardiac arrhythmias due to amoebic liver abscess especially from right lobe are very rare.
    Matched MeSH terms: Electrocardiography
  12. Teh HS, Tan HJ, Loo CY, Raymond AA
    Med J Malaysia, 2007 Jun;62(2):104-8.
    PMID: 18705439
    Epilepsy patients have a higher mortality rate than the general population. Sudden unexpected death in epilepsy (SUDEP) is a major cause of mortality for these patients. The possibility of cardiac involvement in the pathogenesis of SUDEP has been suggested by many previous studies. This study compared the QT interval in epilepsy patients and normal controls, and identified the factors that affected the QT interval. Standard 12-lead ECGs were recorded from 70 consecutive epilepsy patients from the neurology clinic of HUKM and 70 age, race and gender matched controls. The mean QT interval corrected for heart rate (QTc) was calculated and compared. The mean QTc among the epilepsy patients was 0.401 +/- 0.027s. It was significantly shorter than the QTc (0.420 +/- 0.027s) in the control group (p<0.0005). Thirty five epilepsy patients (50%) and 17 matched controls (24.3%) had a mean QTc shorter than 0.40s (p=0.001). Among the epilepsy patients, the mean QTc did not significantly differ between patients in the duration (F=0.836, p=0.438) of the epilepsy, frequency (F=0.273, p=0.845) and types of seizures (p=0.633). There was no significant difference in the mean QTc between the epilepsy patients on different number of antiepileptic agents (F=0.444, p=0.643). Patients with cryptogenic epilepsy had a mean QTc of 0.392 +/- 0.029s, which was significantly shorter than patients with symptomatic epilepsy (QTc = 0.410 +/- 0.027s, p = 0.015). The mean QTc of the same subjects showed no significant interobserver difference (p=0.661). This study, for the first time, demonstrates that epilepsy patients have a significantly shorter QTc than controls, particularly in the subgroup of patients with cryptogenic epilepsy.
    Study site: Neurology clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Electrocardiography*
  13. Yeo CK, Hapizah MN, Khalid BAK, Wan Nazainimoon WM, Khalid Y
    Med J Malaysia, 2004 Jun;59(2):185-9.
    PMID: 15559168
    Diabetes mellitus is an important coronary artery disease risk factor. The presence of microalbuminuria, which indicates renal involvement in diabetic patients, is associated with an increased cardiovascular risk. There are suggestions that diabetic patients with microalbuminuria have more adverse risk profile such as higher ambulatory blood pressure and total cholesterol levels to account for the increased cardiovascular morbidity and mortality. QT dispersion is increasingly being recognized as a prognostic factor for coronary artery disease and sudden death. Some studies have suggested that QT dispersion is an important predictor of mortality in Type II diabetic patients. Our cross sectional study was to compare the QT dispersion and 24 hour ambulatory blood pressure monitoring between diabetic patients with microalbuminuria and those without microalbuminuria. Diabetic patients with overt coronary artery disease were excluded from the study. A total of 108 patients were recruited of which 57 patients had microalbuminuria and 51 were without microalbuminuria. The mean value of QT dispersion was significantly higher in patients with microalbuminuria than in patients without microalbuminuria (58.9 +/- 27.9 ms vs. 47.1 +/- 25.0 ms, p < 0.05). The mean 24 hour systolic and diastolic blood pressures were significantly higher in patients with microalbuminuria than in patients without microalbuminuria (129.5 +/- 12.3 mm Hg vs 122.3 +/- 10.2 mm Hg, p < 0.05 and 78.4 +/- 6.9 mm Hg vs 75.3 +/- 6.8 mm Hg, p < 0.05, respectively). Our study suggests that QT dispersion prolongation, related perhaps to some autonomic dysfunction, is an early manifestation of cardiovascular aberration in diabetic patients with microalbuminuria. The higher blood pressure levels recorded during a 24-hour period min diabetics with microalbuminuria could also possibly account for the worse cardiovascular outcome in this group of patients.
    Matched MeSH terms: Electrocardiography*
  14. Aung T
    Med J Malaysia, 1997 Dec;52(4):441-3.
    PMID: 10968125
    A case of unsuspected penetrating cardiac injury is presented. It was recognised by the presence of bleeding into peritoneal cavity even after the source of bleeding from intra-abdominal organs had been stopped. It highlights the importance of high index of suspicion of associated cardiac injury in high epigastric penetrating injury.
    Matched MeSH terms: Electrocardiography
  15. Mohamed AL, Yusoff K, Muttalif AR, Khalid BAk
    Med J Malaysia, 1999 Sep;54(3):338-45.
    PMID: 11045060
    Sudden cardiac death is a known complication of acromegaly. Little is known of the exact mechanism leading to sudden cardiac death in these patients. Ventricular tachyarrhythmias may be an important cause. If this is so, clinical markers of ventricular tachyarrhythmias may be more common in this group of patients. The presence of these markers allow better risk stratification among acromegalic patients.
    Matched MeSH terms: Electrocardiography
  16. Soh EBS, Raman S, Chia PMK
    Med J Malaysia, 1998 Sep;53(3):280-3.
    PMID: 10968167
    A gravid patient with fetal supraventricular tachycardia is presented. A review of this rare condition and the present recommended mode of therapy are discussed.
    Matched MeSH terms: Electrocardiography*
  17. Khalid Y
    Med J Malaysia, 1994 Jun;49(2):174-5.
    PMID: 8090099
    Pulsus alternans, the alternating strong and week pulses which occur in patients with severe heart failure, was first described by Traube in 1872. Since then various methods, both invasive1,2 and non-invasive3,4, have been used to study this phenomenon. This study demonstrates the utility of using simultaneous electrocardiography (ECG) and Doppler echocardiography to document pulsus alternans, and to differentiate it from other causes of alternating pulses.
    Matched MeSH terms: Electrocardiography*
  18. Sufarlan AW, Khalid BA
    Med J Malaysia, 1989 Dec;44(4):334-40.
    PMID: 2520044
    Four cases of acute viral myocarditis were diagnosed within three weeks. The clinical features, electrocardiography, cardiac enzymes and other laboratory investigations are described.
    Matched MeSH terms: Electrocardiography
  19. Ong PK, Ramanathan M
    Med J Malaysia, 1987 Sep;42(3):215-6.
    PMID: 3506649
    We report a case of transient complete heart block with Stokes-Adams attack due to acute rheumatic fever. The patient was a 12-year old boy whose illness satisfied the criteria of acute rheumatic fever. A temporary transvenous cardiac pacer was necessary to tide him over the complete heart block. The rarity of this complication of acute rheumatic fever is highlighted.
    Matched MeSH terms: Electrocardiography
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