Displaying publications 1 - 20 of 266 in total

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  1. Othman IA, Hashim ND, Nazimi AJ
    Case Rep Med, 2018;2018:4053531.
    PMID: 29861735 DOI: 10.1155/2018/4053531
    The number of maxillofacial trauma (MFT) cases attended in the Emergency Department is progressively increasing in trend, owing to the rising statistics of motor-vehicle accidents (MVAs) and urban assaults in addition to occupational-related injuries. Prompt and thorough assessment is important for accurate diagnosis and paramount treatment plans. We will be discussing a case of unusual presentation of an orbital floor fracture post-MVA which was treated conservatively based on the clinical assessments during follow-ups, supported by radiological findings. We will also briefly discuss the different radiological modalities available in assessing MFT and late presentation of enophthalmos.
    Matched MeSH terms: Emergency Service, Hospital
  2. Yeoh C, Teo A, Azhar AMN, Suann ST, Thum Y, Wong KD, et al.
    J Acute Med, 2019 Sep 01;9(3):128-144.
    PMID: 32995241 DOI: 10.6705/j.jacme.201909_9(3).0005
    Background: Balanced fluids are preferred in initial resuscitation of septic patients based on several recent studies. The Stewart's concept on acid-base balance predicts that high strong ion difference (SID) fluid thus will increase the pH level. To date, the impact of high SID fluid in septic patient with metabolic acidosis remains uncertain. We conducted single center, randomized, double-blind trial to compare the effect of high SID fluid vs. Hartmann's solution on acid-base status in selected sepsis patients in the Emergency Department.

    Methods: Septic patient with hyperlactatemia and metabolic acidosis were randomized to receive either high SID fl uid or Hartmann's solution during initial fl uid resuscitation. The primary outcome measures the pH and bicarbonate levels difference pre- and post- resuscitation.

    Results: One hundred and sixty-two patients underwent randomization, 81 were assigned each to receive high SID fluid or Hartmann's solution. Both groups had similar baseline characteristics. High SID group received 23.5 mL/kg and the Hartmann's group received 22.7 mL/kg (p = 0.360). High SID fluid increased the mean (± SD) pH by 0.107 (± 0.09) vs. Hartmann's solution by 0.014 (± 0.12), p ≤ 0.001. Mean bicarbonate level increased signifi cantly in high SID group compared to Hartmann's (4.30 ± 3.76 vs. 1.25 ± 3.33, p ≤ 0.001). High SID group had higher post resuscitation lactate clearance than Hartmann's group (25.4 ± 28.3% vs. 12.0 ± 34.1%, p = 0.009). Shorter hospital stay was observed in highSID group 8.04 ± 5.96 days vs. Hartmann's group 12.18 ± 12.41 days (p = 0.048). Both groups showed no difference in incidence of pulmonary oedema, acute kidney injury and mortality.

    Conclusions: Initial resuscitation using high SID fluid in selected septic patient improves pH and bicarbonate levels. The high SID group had better post resuscitation lactate clearance and shorter hospital stay.

    Matched MeSH terms: Emergency Service, Hospital
  3. Kurnaz R, Ikizler M, Ozbayburtlu M, Gunes T
    Malays Orthop J, 2018 Mar;12(1):51-53.
    PMID: 29725515 DOI: 10.5704/MOJ.1803.012
    Proximal humerus fracture is a common arm trauma and rarely occurs with vascular injury which however is a serious complication. In this case report, we present a long segment dissection of the axillary and brachial arteries as a rare complication due to fragmented proximal humerus fracture and shoulder dislocation. An 80-year old female patient was seen at the emergency department. Radiograph examination has revealed a fragmented proximal humerus fracture besides dislocation of the head of humerus towards the axillary area. On vascular examination, acute arterial occlusion such as absence of radial and ulnar pulses were observed in her left hand. The patient was immediately taken to the operating room. The dissection included the entire segment approximately 20cm between the distal subclavian artery and the distal brachial artery. This injured segment was removed and a 6mm Polytetrafluroethylene (PTFE) graft with rings was interpositoned between subclavian and brachial arteries. This case is a rarity because of such a significant complication after a small injury. Axillary artery injuries caused by humeral neck fractures are rare but should not be missed by the physician.
    Matched MeSH terms: Emergency Service, Hospital
  4. Lee CY, Osman SS, Noor HM, Isa NSA
    Sultan Qaboos Univ Med J, 2018 Nov;18(4):e541-e544.
    PMID: 30988978 DOI: 10.18295/squmj.2018.18.04.020
    A congenital pulmonary airway malformation (CPAM) is a rare cystic anomaly that may occur during development of the fetal airways. The vast majority of CPAMs are detected in neonates; as such, it is unusual for diagnosis to occur in adulthood. We report a 21-year-old male patient who presented to the emergency department of the Hospital Ampang, Kuala Lumpur, Malaysia, in 2015 with chest pain, breathlessness and tachypnoea. Based on an initial chest X-ray, the patient was misdiagnosed with pneumothorax and underwent urgent chest tube insertion; however, his condition deteriorated over the course of the next three days. Further imaging was suggestive of infected bullae or an undiagnosed CPAM. The patient therefore underwent video-assisted thoracoscopic surgery, during which a large infected bulla was resected. A diagnosis of an infected CPAM was confirmed by histopathological examination. Following the surgery, the patient recovered quickly and no bullae remnants were found at a one-month follow-up.
    Matched MeSH terms: Emergency Service, Hospital/organization & administration; Emergency Service, Hospital/statistics & numerical data
  5. Ong HY, Ng JJ, Nadhrah MN, Shaariyah MM, Shashi G
    Turk Arch Otorhinolaryngol, 2020 Jun;58(2):130-132.
    PMID: 32783042 DOI: 10.5152/tao.2020.5095
    Pseudomembranous tracheitis is a rare life-threatening complication of endotracheal intubation. The exact mechanism of its formation is not well known, and it could mimic crusting or retained secretions in the trachea. We encountered a patient with history of recent intubation, presenting with acute stridor requiring emergency airway stabilization, and was eventually found to have pseudomembranous tracheitis.
    Matched MeSH terms: Emergency Service, Hospital
  6. Isamil Saiboon, Ho, Siew Eng, Krishnan, Bala, Siti Norraini Ali, Noorafindi Murad, Pathnathan, Audrey, et al.
    Medicine & Health, 2008;3(1):7-13.
    MyJurnal
    Patients’ satisfaction is of critical interest to all healthcare providers. Satisfied patients are more likely to seek health care and to comply with prescribed treatment regimes. The objective of the study was to identify factors that influence patient satisfaction with Emergency Department HUKM (ED HUKM). This study was conducted at ED HUKM from January 2007 till March 2007. A convenience sample of 100 participants was recruited from triage 4. The Davis Consumer Emergency Care Satisfaction Scale (CECSS) was adopted and modified. It consists of 19 questions; used a 5 point, Likert type scale of 1 to 5 (1= completely disagree and 5= completely agree) to measure patient satisfaction with triage, health care providers caring behaviours and health teaching. Results showed that 75 participants (75%) were satisfied. There were no significant difference found between male and female patients with total CESCC scores (t=0.308, p values >0.05). Pearson product moment correlation coefficients showed a positive relationship between total and subscale patient satisfaction scores, caring scores (r=0.905, p value
    Matched MeSH terms: Emergency Service, Hospital
  7. Chew KS, Wan Masliza WM, Nik Hisamuddin NA, Mohd Hashairi F, Shaik Farid AW, Tuan Hairulnizam TK, et al.
    Med J Malaysia, 2015 Feb;70(1):6-11.
    PMID: 26032522 MyJurnal
    BACKGROUND: Good coronary care begins from the patient's home, including early transportation. As such, it is recommended that the patients activate ambulances, rather than to use their own transportations to reach the hospitals. It is not known whether Malaysian patients prefer to use private transportations or ambulances when they develop chest pain.

    OBJECTIVES: This study is conducted to explore the question of the choice of transportation modes among patients with acute coronary syndrome and the reasons behind their choices.

    METHODS: This is a structured interview survey on patients diagnosed with acute coronary syndrome (ACS) in emergency department of Hospital Universiti Sains Malaysia from April 2012 to September 2012.

    RESULTS: Out of the 110 patients surveyed, 105 (95.5%) patients chose to use own transportation when they developed symptoms suggestive of ACS. Only 3 patients (2.7%) came to the emergency department within 1 hour of onset, and all these 3 patients chose to use ambulances as their modes of transportation. None of the patients who chose own transportation came within the first hour of symptoms onset. This is shown to be statistically significant (p<0.001). The level of education as well as past history of ischemic heart disease did not significantly influence the patients' choice of transportation.

    CONCLUSION: The admonishment by various international resuscitation councils that patients with chest pain should be transported via ambulances may not be as straightforward as it seems. Numerous local and regional socio-cultural and logistic factors may need to be addressed.
    Matched MeSH terms: Emergency Service, Hospital
  8. Ismail AK, Weinstein SA, Auliya M, Sabardin DM, Herbosa TJ, Saiboon IM, et al.
    Clin Toxicol (Phila), 2010 Mar;48(3):222-6.
    PMID: 20345298 DOI: 10.3109/15563650903550964
    The Twin-Barred Tree Snake, Chrysopelea pelias, is a colubrine that, like other members of the genus Chrysopelea, is able to glide in the arboreal strata. Little is known about the effects of its bite. This report is the first clinically documented bite by this relatively uncommon rear-fanged species.
    Matched MeSH terms: Emergency Service, Hospital
  9. Koh, B.Y.E., Norharlina, B.
    MyJurnal
    The authors report a case of co-morbid diagnosis Anorexia Nervosa (AN) with co-morbid diagnosis of Obsessive-compulsive Disorder (OCD) by proxy. The patient is a 16-year-old female who presented to the emergency department with features of AN and also OCD. To reduce the anxiety of her AN, she incorporated her mother as a proxy to follow specific instructions. The patient received both inpatient and outpatient support, and her condition gradually improved with antidepressants and antipsychotics. This case illustrates a co-morbid presentation of OCD with AN and also the result of family accommodation that led to the family member aiding with the compulsion. Treatment for the case was also briefly discussed.
    Study site: emergency department (unspecified)
    Matched MeSH terms: Emergency Service, Hospital
  10. Abd Hamid H, Umar NA, Othman H, Das S
    Arch Med Sci, 2010 Dec;6(6):987-90.
    PMID: 22427779 DOI: 10.5114/aoms.2010.19315
    Hyperosmolar hyperglycaemic state (HHS) is a medical emergency which needs immediate medical intervention. A 37-year-old Chinese woman with a history of hypertension attended the Emergency Department. She had a two-day history of involuntary movement, i.e. chorea of the upper limbs, preceded by a one-week history of upper respiratory tract infection. She also had polyuria and polydipsia, although she was never diagnosed as diabetic. The main aim of reporting the present case was to highlight the importance of biochemical investigations involved in the diagnosis of involuntary movements.
    Study site: emergency department, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
    Matched MeSH terms: Emergency Service, Hospital
  11. Tan TL, Chung WM
    Med J Malaysia, 2017 04;72(2):141-143.
    PMID: 28473684 MyJurnal
    Erythroderma can be life-threatening, primarily because of its metabolic burden and complications. It is mandatory to establish its etiopathology in order to facilitate precise and definitive management. This disorder may be the morphologic presentation of a variety of cutaneous and systemic diseases. Detailed history and thorough work-up is therefore essential. Management of erythroderma involves multi-disciplines with progress monitoring especially on signs and symptoms suggestive of acute skin failure induced complications. Early diagnosis and referral of erythroderma to centres with dermatological services is crucial and will directly affect the outcome of the patients.
    Matched MeSH terms: Emergency Service, Hospital
  12. Jin QW, Jeswant Dillon J, Tjen Jhung L, Isman Rusani B
    Eur Heart J Case Rep, 2020 Dec;4(6):1-5.
    PMID: 33442636 DOI: 10.1093/ehjcr/ytaa441
    Background : Sinus of Valsalva aneurysm (SoVA) is a rare anomaly and can be divided into acquired and congenital forms, the latter being commonly associated with ventricular septal defects (VSDs). Rupture is a catastrophic complication with high mortality without urgent surgical intervention. We would like to highlight the use of echocardiography in an emergency setting for diagnosis and surgical intervention in a critically ill patient.

    Case summary : We report a 27-year-old female with history of conservatively managed VSD known since childhood. She presented with acute decompensated cardiac failure requiring intubation and inotropic support. Bedside echocardiography performed in the emergency department suggested a ruptured SoVA at the right coronary cusp with underlying supracristal VSD. Despite the patient being critically ill with multi-organ failure, surgery was performed as it was the patient's best chance for survival. Intraoperative findings tallied with the early echocardiographic results. She recovered gradually and was eventually discharged despite a stormy post-operative period.

    Discussion : This case report highlights the importance of prompt recognition of SoVA rupture by using bedside echocardiography. Surgical intervention needs to be early despite ongoing sepsis in view of acute mechanical failure. This case was unique as it illustrates a successful management of an acutely ill patient with multi-organ failure through early diagnosis, intensive perioperative stabilization, and surgical intervention.

    Matched MeSH terms: Emergency Service, Hospital
  13. Fadzil FM, Choon D, Arumugam K
    Aust Fam Physician, 2010 Apr;39(4):237-9.
    PMID: 20372685
    This study assessed the concordance of the temperatures of the digital, liquid crystal forehead and digital infrared tympanic thermometers with the mercury in glass thermometer.
    Matched MeSH terms: Emergency Service, Hospital
  14. Ahmad A, Patel I, Asani H, Jagadeesan M, Parimalakrishnan S, Selvamuthukumaran S
    Indian J Pharmacol, 2015 Jan-Feb;47(1):90-4.
    PMID: 25821318 DOI: 10.4103/0253-7613.150360
    Antithrombotic therapy with heparin plus antiplatelets reduces the rate of ischemic events in patients with coronary heart disease. Low molecular weight heparin has a more predictable anticoagulant effect than standard unfractionated heparin, is easier to administer, does not require monitoring and is associated with less ADRs. The purpose of the present study was to evaluate and compare the clinical and cost outcomes of Enoxaparin with a standard unfractionated heparin in patients with coronary heart disease.
    Matched MeSH terms: Emergency Service, Hospital
  15. Narwani Hussin, Yvonne Ai Lian Lim, Pik Pin Goh, Timothy William, Jenarun Jelip, Rose Nani Mudin
    MyJurnal
    Introduction: Most of the recent publications on malaria in Malaysia were conducted in Sabah focusing on the emer-gence of Plasmodium knowlesi. This analysis aims to look into the incidence, mortality, and case fatality rate (CFR) of malaria caused by all Plasmodium species in the whole of Malaysia and to compare the different malaria char-acteristics and trends between Peninsular Malaysia (PM) and Sabah & Sarawak. Methods: This is a secondary data review of all malaria confirmed cases notified to the Ministry of Health, Malaysia from January 2013 to December 2017. Results: From 2013 to 2017, a total of 16,500 malaria cases were notified in Malaysia. The cases were mainly contributed from Sabah (7,150; 43.3%) and Sarawak (5,684; 34.4%). Plasmodium knowlesi was the commonest species in Sabah and Sarawak (9,902; 77.1%), while there were more Plasmodium vivax cases (1,548; 42.2%) in PM. The overall average incidence rates (IR), mortality rate (MR) and CFR for malaria in Malaysia were 0.106/1,000, 0.030/100,000 and 0.27%, respectively. Sarawak reported the highest average IR of 0.420/1,000 followed by Sabah (0.383/1,000). Other states in PM reported below the national average IR with
    Matched MeSH terms: Emergency Service, Hospital
  16. Chew BH, Than TL, Chew KS, Jamaludin NK, Hassan H
    Med J Malaysia, 2012 Dec;67(6):571-6.
    PMID: 23770947 MyJurnal
    INTRODUCTION: Our study was to examine prevalence and treatment outcomes of medical emergencies at two urban public health clinics in the Petaling district, Selangor, Malaysia.
    METHODS: A prospective universal sampling was employed to recruit all emergencies over one month period (12 April to 11 May 2011). A structured case record form was used to capture demographic data, whether the index case was selfpresenting or decided by health care workers as a medical emergency, presenting complaints, diagnoses, concurrent chronic diseases and their treatment outcomes at the clinic level. Emergency presentations and diagnoses were classified according to the International Classification of Primary Care, revised second edition (ICPC-2-R).
    RESULTS: A total of 125 medical emergencies with 276 presenting complaints were recorded. The mean age was 30.7 years old (SD 19.9). The prevalence of medical emergency was 0.56% (125/22,320). Chief complaints were mainly from ICPC-2-R chapter R (respiratory system) and chapter A (general and unspecified), 40.0% and 28.0% respectively. The most common diagnosis was acute exacerbation of bronchial asthma (34.6%). Forty percent were referred to hospitals. After adjusting for age and gender, patients who presented with painful emergency (OR 4.9 95% CI 2.0 to 11.7), cardiovascular emergency (OR 63.4 95% CI 12.9 to 310.4) and non-respiratory emergency were predictors of hospital referral (OR 4.6 95% CI 1.1 to 19.1).
    CONCLUSION: There was about one medical emergency for every 200 patients presenting to these urban public polyclinics which were mainly acute asthma. More than half were discharged well and given a follow-up.
    Study site: Klinik Kesihatan Seri Kembangan and Klinik Kesihatan Puchong, Selangor, Malaysia
    Matched MeSH terms: Emergency Service, Hospital
  17. Morton TD
    J Emerg Med, 1992 7 11;10(4):485-8.
    PMID: 1430987
    The author spent 6 months as director of a major university hospital accident and emergency department in Kuala Lumpur, Malaysia. A brief summary of this experience is provided, followed by a series of recommendations based on the experience that may provide some guidance in future efforts to establish emergency medicine in developing areas of the world.
    Matched MeSH terms: Emergency Service, Hospital
  18. Fathil SM, Mohd Mahdi SN, Che'man Z, Hassan A, Ahmad Z, Ismail AK
    Int J Emerg Med, 2010;3(4):233-7.
    PMID: 21373289 DOI: 10.1007/s12245-010-0201-0
    BACKGROUND: Airway management is an important part of the management of the critically ill and injured patients in the Emergency Department (ED). Numerous studies from developed countries have demonstrated the competency of emergency doctors in intubation. To date there have been no published data on intubations performed in EDs in Malaysia.
    METHODS: Data on intubations from 7 August 2007 till 28 August 2008 were prospectively collected.
    RESULTS: There were 228 intubations included in the study period. Cardiopulmonary arrest was the main indication for intubation (35.5%). The other indications were head injury (18.4%), respiratory failure (15.4%), polytrauma (9.6%) and cerebrovascular accident (7.0%). All of the 228 patients were successfully intubated. Rapid sequence intubation (RSI) was the most frequent method (49.6%) of intubation. A total of 223 (97.8%) intubations were done by ED personnel. In 79.8% of the cases, intubations were successfully performed on the first attempt. Midazolam was the most common induction agent used (97 patients), while suxamethonium was the muscle relaxant of choice (109 patients). There were 34 patients (14.9%) with 38 reported immediate complications. The most common complication was oesophageal intubation.
    CONCLUSION: Emergency Department UKMMC personnel have a high competency level in intubation with an acceptable complication rate. RSI was the most common method for intubation.
    KEYWORDS: Airway; Intubation; Orotracheal intubation; Rapid sequence intubation
    Matched MeSH terms: Emergency Service, Hospital
  19. Rahman NH, DeSilva T
    J Emerg Med, 2012 Dec;43(6):951-7.
    PMID: 23068783 DOI: 10.1016/j.jemermed.2012.02.069
    The use of patient-controlled analgesia (PCA) has been reported to provide effective pain relief, often resulting in less opioid consumption, and is associated with greater patient satisfaction when it is compared to other techniques of analgesia delivery.
    Matched MeSH terms: Emergency Service, Hospital*
  20. Yousuf R, Abdul Aziz S, Yusof N, Leong CF
    Indian J Hematol Blood Transfus, 2014 Sep;30(3):208-10.
    PMID: 25114411 DOI: 10.1007/s12288-012-0211-6
    We report a 47-year-old Malay lady, para 4 + 1, with known medical history of hypertension whom presented at Emergency Department with severe anaemia, most likely secondary to menorrhagia caused by uterine fibroids. Her haemoglobin was 5.5 g/dl and she was transfused with three units of packed cell without any adverse reaction, her haemoglobin level increased to 9.8 g/dl. She was then planned for total abdominal hysterectomy and bilateral salpingo-oophorectomy later. Four months later when she came for the elective surgery, her pre transfusion investigations showed blood group as B Rh D positive, with a probable R1R1 phenotype. Her antibody screening was positive in all the three panel cells. Further testings showed a negative Direct Coomb's test and negative autocontrol, antibody identification showed pan-agglutination reaction on all 11 panel cells with enzyme enhancement. Patient's red cell phenotype was Jk(a-b-). Anti-Jk3 was suspected and further confirmed in the reference laboratory by phenotyping as well as negative urea lysis test. This case report highlights an extremely rare but clinically significant anti-JK3 antibody detected during pretransfusion testing. This phenotype is rare in the white population, more commonly seen in various polynesians. Increased awareness among the blood bank personnel regarding the variability of the blood group phenotype and the capricious nature of the Kidd antibodies may contribute to the better management of these patients.
    Matched MeSH terms: Emergency Service, Hospital
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