Displaying publications 1 - 20 of 42 in total

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  1. Tay SK, Leong YP, Meah FA, Abdullah T, Zain AR
    Med J Malaysia, 1992 Dec;47(4):267-72.
    PMID: 1303478
    Bleeding gastroesophageal varices is associated with a high morbidity and mortality. Forty-four cases of bleeding gastroesophageal varices were treated at the Department of Surgery, Universiti Kebangsaan Malaysia, General Hospital, Kuala Lumpur over four and a half years. Thirty-two of them had liver cirrhosis. Hepatitis B infection was noted in 13 and alcoholic abuse was present in 14 patients. Five patients had associated hepatoma. Thirty-four percent had gastric fundal varices and a third of these bled from them. A total of 179 endoscopic injection sclerotherapy sessions were performed averaging 4 per person. Rebleeding rate was 4% and mortality was high (50%) in these cases. It was concluded that injection sclerotherapy is a safe and effective means of controlling bleeding oesophageal varices. Operative surgery was employed in those who rebled after injection and would be considered in those in Child's A.
    Matched MeSH terms: Gastrointestinal Hemorrhage/therapy*
  2. Jacob SP, Nath S, Zade RM
    Indian J Dent Res, 2012 Nov-Dec;23(6):714-8.
    PMID: 23649051 DOI: 10.4103/0970-9290.111244
    Periodontitis is a potential risk factor for adverse pregnancy outcomes due to the presence of a subgingival load of pathogenic bacteria. Instrumentation of periodontal pockets during treatment may result in bacteremia and/or endotoxemia.
    Matched MeSH terms: Gingival Hemorrhage/therapy
  3. Pourshahrestani S, Kadri NA, Zeimaran E, Gargiulo N, Samuel S, Naveen SV, et al.
    Biomed Mater, 2018 02 08;13(2):025020.
    PMID: 29148431 DOI: 10.1088/1748-605X/aa9b3e
    Mesoporous bioactive glass containing 1% Ga2O3 (1%Ga-MBG) is attractive for hemorrhage control because of its surface chemistry which can promote blood-clotting. The present study compares this proprietary inorganic coagulation accelerator with two commercial hemostats, CeloxTM (CX) and QuikClot Advanced Clotting Sponge PlusTM (ACS+). The results indicate that the number of adherent platelets were higher on the 1%Ga-MBG and CX surfaces than ACS+ whereas a greater contact activation was seen on 1%Ga-MBG and ACS+ surfaces than CX. 1%Ga-MBG not only resulted in larger platelet aggregates and more extensive platelet pseudopodia compared to CX and ACS+ but also significantly accelerated the intrinsic pathways of the clotting cascade. In vitro thrombin generation assays also showed that CX and ACS+ induced low levels of thrombin formation while 1%Ga-MBG had significantly higher values. 1%Ga-MBG formed a larger red blood cell aggregate than both CX and ACS+. Direct exposure of 1%Ga-MBG to fibroblast cells increased cell viability after 3 days relative to CX and ACS+, inferring excellent cytocompatibility. The results of this study promote 1%Ga-MBG as a promising hemostat compared to the commercially available products as it possesses essential factors required for coagulation activation.
    Matched MeSH terms: Hemorrhage/therapy*
  4. Nyin LY, Zainun AR, Tee HP
    Med J Malaysia, 2011 Aug;66(3):257-8.
    PMID: 22111453 MyJurnal
    Jejunal diverticulosis is a rare gastrointestinal condition manifested as benign outpouching from the jejunal wall. It is usually asymptomatic, but may present as obscure gastrointestinal bleeding. This condition is often found incidentally in the imaging work-up of patients with other gastrointestinal conditions. We present a case of jejunal diverticulosis in a 65-year-old gentleman with obscure overt gastrointestinal bleed.
    Matched MeSH terms: Gastrointestinal Hemorrhage/therapy
  5. Lakhwani MN, Ismail AR, Barras CDJ, Tan WJ
    Med J Malaysia, 2000 Dec;55(4):498-505.
    PMID: 11221164
    Despite advancements in endoscopy and pharmacology in the treatment of peptic ulcer disease the overall mortality has remained constant at 10% for the past four decades. The aim of this study was to determine the age, gender, racial distribution, incidence and causes of endoscopically diagnosed cases of upper gastrointestinal (UGI) bleeding to summarise treatments undertaken and to report their outcome. A prospective study of UGI bleeding in 128 patients was performed in two surgical wards of Kuala Lumpur Hospital, involving both elective and emergency admissions. The study group comprised of 113 (88.2%) males and 15 (11.7%) females. The mean age was 51.9 years (range 14 to 85 years) and 37.5% (48 of 128 patients) were older than 60 years. The Indian race was over-represented in all disease categories. Smoking (50.1%), alcohol consumption (37.5%), non-steroidal anti-inflammatory drugs (NSAIDs) (17.2%), traditional remedies (5.5%), anti-coagulants (2.3%) and steroids (0.8%) were among the risk factors reported. Common presenting symptoms and signs included malaena (68.8%), haematemesis (59.4%) and fresh per rectal bleeding (33.6%). The commonest causes of UGI bleeding were duodenal ulcer (32%), gastric ulcer (29.7%), erosions (duodenal and gastric) (21.9%), oesophageal varices (10.9%) and malignancy (3.9%). UGI bleeding was treated non-surgically in 90.6% of cases. Blood transfusions were required in 62.6% (67/107) of peptic ulcer disease patients. Surgical intervention for bleeding peptic ulcer occurred in around 10% of cases and involved under-running of the bleeding vessel in most high risk duodenal and gastric ulcer patients. The overall mortality from bleeding peptic ulcer disease was 4.7%. Six patients died from torrential UGI haemorrhage soon after presentation, without the establishment of a cause. Active resuscitative protocols, early endoscopy, more aggressive interventional therapy, early surgery by more senior surgeons, increasing intensive care unit beds and more active participation of multidisciplinary teams in co-ordinating management are among remedial measures advocated. Broader educational preventive strategies should target the causes of UGI bleeding.
    Matched MeSH terms: Gastrointestinal Hemorrhage/therapy*
  6. Khor CG, Kan SL, Tan BE
    Int J Rheum Dis, 2018 Jun;21(6):1322-1325.
    PMID: 24495523 DOI: 10.1111/1756-185X.12302
    We report a 29-year-old Malay man who had pulmonary manifestations as an initial presentation for systemic lupus erythematosus. He had prolonged hospitalization and was treated with intensive care therapy with immunosuppressants.
    Matched MeSH terms: Hemorrhage/therapy
  7. Law ZK, Appleton JP, Scutt P, Roberts I, Al-Shahi Salman R, England TJ, et al.
    Stroke, 2022 Apr;53(4):1141-1148.
    PMID: 34847710 DOI: 10.1161/STROKEAHA.121.035191
    BACKGROUND: Seeking consent rapidly in acute stroke trials is crucial as interventions are time sensitive. We explored the association between consent pathways and time to enrollment in the TICH-2 (Tranexamic Acid in Intracerebral Haemorrhage-2) randomized controlled trial.

    METHODS: Consent was provided by patients or by a relative or an independent doctor in incapacitated patients, using a 1-stage (full written consent) or 2-stage (initial brief consent followed by full written consent post-randomization) approach. The computed tomography-to-randomization time according to consent pathways was compared using the Kruskal-Wallis test. Multivariable logistic regression was performed to identify variables associated with onset-to-randomization time of ≤3 hours.

    RESULTS: Of 2325 patients, 817 (35%) gave self-consent using 1-stage (557; 68%) or 2-stage consent (260; 32%). For 1507 (65%), consent was provided by a relative (1 stage, 996 [66%]; 2 stage, 323 [21%]) or a doctor (all 2-stage, 188 [12%]). One patient did not record prerandomization consent, with written consent obtained subsequently. The median (interquartile range) computed tomography-to-randomization time was 55 (38-93) minutes for doctor consent, 55 (37-95) minutes for 2-stage patient, 69 (43-110) minutes for 2-stage relative, 75 (48-124) minutes for 1-stage patient, and 90 (56-155) minutes for 1-stage relative consents (P<0.001). Two-stage consent was associated with onset-to-randomization time of ≤3 hours compared with 1-stage consent (adjusted odds ratio, 1.9 [95% CI, 1.5-2.4]). Doctor consent increased the odds (adjusted odds ratio, 2.3 [1.5-3.5]) while relative consent reduced the odds of randomization ≤3 hours (adjusted odds ratio, 0.10 [0.03-0.34]) compared with patient consent. Only 2 of 771 patients (0.3%) in the 2-stage pathways withdrew consent when full consent was sought later. Two-stage consent process did not result in higher withdrawal rates or loss to follow-up.

    CONCLUSIONS: The use of initial brief consent was associated with shorter times to enrollment, while maintaining good participant retention. Seeking written consent from relatives was associated with significant delays.

    REGISTRATION: URL: https://www.isrctn.com; Unique identifier: ISRCTN93732214.

    Matched MeSH terms: Cerebral Hemorrhage/therapy
  8. Nawawi O, Young N, So S
    Australas Radiol, 2006 Feb;50(1):21-6.
    PMID: 16499722
    This is a retrospective study to evaluate our early experience of using selective microcoil embolization in patients who had gastrointestinal (GI) haemorrhage. From December 2002 to December 2003, six patients with GI haemorrhage (upper GI, n = 1; lower GI, n = 5) underwent superselective microcoil embolization. Microcatheters were used to carry out embolizations in branches of the superior mesenteric artery. Microcoils were used in five patients and a combination of microcoils and embolospheres was used in one patient. Technical success (bleeding target devascularization) was achieved in all patients who showed active bleeding at the time of angiography. Two patients had recurrent bleeding within 24 h of embolization, of which one (16.7%) died. The other patient did not require active intervention as bleeding was minimal and resolved with conservative management. Satisfactory clinical success (no rebleeding after 30 days) was achieved in five patients. No clinical signs and symptoms of bowel ischaemia occurred in these patients. Follow-up colonoscopy carried out in two patients did not show any signs of ischaemia in the affected bowel segments. Superselective microcoil embolization is an effective and safe method of controlling and arresting bleeding in GI haemorrhage.
    Matched MeSH terms: Gastrointestinal Hemorrhage/therapy*
  9. Leow VM, Siam F, Kannan S, Sari Baharudin M, Raman K, Singh H
    Med J Malaysia, 2013 Jun;68(3):271-2.
    PMID: 23749023 MyJurnal
    A bleeding pseudoaneurysm of the peripancreatic artery can present with massive upper gastrointestinal hemorrhage. History of pancreatitis and urgent imaging are crucial in the making of the diagnosis. Here, we report a patient with alcoholic chronic pancreatitis presented with ruptured pseudoaneurysm of gastroduodenal artery (GDA). He was treated with percutaneous angiographic embolisation.
    Matched MeSH terms: Gastrointestinal Hemorrhage/therapy
  10. Singh AH
    Scott Med J, 2011 Feb;56(1):59.
    PMID: 21515535 DOI: 10.1258/smj.2010.010026
    A 3-year old girl presented to our A&E with a complaint of an acute event of per rectal bleed. The parent had given a history of a visit to a nearby waterfall one day ago. Upon admission she developed hypotension and had a fainting episode due to the excessive passing of blood per rectum. The case report shows how the appropriate investigations were carried out and the twist behind the cause.
    Matched MeSH terms: Hemorrhage/therapy
  11. Siow SL, Mahendran HA, Seo CJ
    Int J Colorectal Dis, 2017 Jan;32(1):131-134.
    PMID: 27527929 DOI: 10.1007/s00384-016-2635-1
    PURPOSE: The management of haemorrhagic radiation proctitis is challenging because of the necessity for repeated intervention. The efficacy of argon plasma coagulation has been described before but the optimum treatment strategy remains debatable. This is a review of our experience over a decade treating patients with haemorrhagic radiation proctitis and their follow-up.

    METHODS: This is a retrospective review of consecutive patients who underwent argon plasma coagulation for haemorrhagic radiation proctitis between January 2003 and December 2013. The patients were followed up using a prospectively maintained database.

    RESULTS: Ninety-one patients were included with a mean follow-up of 13.1 months. Majoity (n = 85, 93.4 %) of the patients were female. Mean age at the time of treatment was 58.2 (range 23-87) years old. Majority of the patients (n = 73, 80.2 %) received radiotherapy for gynaecological malignancies followed by colorectal (n = 13, 14.3 %) and urological (n = 5, 5.5 %) malignancies. Mean interval between radiation and proctitis was 13.8 (range 3-40) months. Seventy-nine percent of patients were successfully treated after 1-2 sessions. Seventeen (18.7 %) patients experienced self-limiting early complications, and three (3.3 %) had late complications of rectal stenosis which was managed conservatively. Severity of bleeding during the initial presentation is an independent factor that predicts the number of sessions required for successful haemostasis (p = 0.002).

    CONCLUSIONS: Argon plasma coagulation is a reasonable treatment option in patients with haemorrhagic radiation proctitis with good safety profile. Our study suggests that the number of APC sessions required to arrest bleeding correlates with the severity of bleeding on initial presentation.

    Matched MeSH terms: Gastrointestinal Hemorrhage/therapy*
  12. Lei CC, Khairullah A, Zulfiqar A, Samad AS
    Med J Malaysia, 1992 Dec;47(4):320-2.
    PMID: 1303487
    This case report illustrates how a life-threatening renal bleeding which has failed to be controlled by open surgery can be elegantly managed by a minimally invasive technique of interventional radiology. It also allows maximal conservation of renal tissue so that the patient can avoid chronic dialysis or renal transplantation.
    Matched MeSH terms: Hemorrhage/therapy
  13. Pui WC, Chieng TH, Siow SL, Nik Abdullah NA, Sagap I
    Asian Pac J Cancer Prev, 2020 Oct 01;21(10):2927-2934.
    PMID: 33112550 DOI: 10.31557/APJCP.2020.21.10.2927
    BACKGROUND: Various methods have been used for treatment of hemorrhagic radiation proctitis (HRP) with variable results. Currently, the preferred treatment is formalin application or endoscopic therapy with argon plasma coagulation. Recently, a novel therapy with colonic water irrigation and oral antibiotics showed promising results and more effective compared to 4% formalin application for HRP. The study objective is to compare the effect of water irrigation and oral antibiotics versus 4% formalin application in improving per rectal bleeding due to HRP and related symptoms such as diarrhoea, tenesmus, stool frequency, stool urgency and endoscopic findings.

    METHODS: We conducted a study on 34 patients with HRP and randomly assigned the patients to two treatment arm groups (n=17). The formalin group underwent 4% formalin dab and another session 4 weeks later. The irrigation group self-administered daily rectal irrigation at home for 8 weeks and consumed oral metronidazole and ciprofloxacin during the first one week. We measured the patients' symptoms and endoscopic findings before and after total of 8 weeks of treatment in both groups.

    RESULTS: Our study showed that HRP patients had reduced per rectal bleeding (p = 0.003) in formalin group, whereas irrigation group showed reduced diarrhoea (p=0.018) and tenesmus (p=0.024) symptoms. The comparison between the two treatment arms showed that irrigation technique was better than formalin technique for tenesmus (p=0.043) symptom only.

    CONCLUSION: This novel treatment showed benefit in treating HRP. It could be a new treatment option which is safe and conveniently self-administered at home or used as a combination with other therapies to improve the treatment outcome for HRP.
    .

    Matched MeSH terms: Gastrointestinal Hemorrhage/therapy*
  14. Soon CK, Razak M
    Med J Malaysia, 2001 Dec;56 Suppl D:57-60.
    PMID: 14569769
    Hemorrhagic lumbar synovial cysts are not commonly reported in English literature. Post-resection recurrence of synovial cyst is unusual and therefore recurrence symptoms required repeat MRI or CT scan. We reported a case of hemorrhagic lumbar synovial cyst presented with neurological deficit that recovered initially after surgery but subsequently developed recurrent of symptoms at a higher level due to fibrous tissue.
    Matched MeSH terms: Hemorrhage/therapy
  15. Rachagan SP, Sivanesaratnam V, Kok KP, Raman S
    Aust N Z J Obstet Gynaecol, 1988 Feb;28(1):29-32.
    PMID: 3214380
    Over a 17-year period, 15 patients with acute puerperal inversion of the uterus were managed at the University Hospital, Kuala Lumpur, an incidence of 1 in 4,836 deliveries. Injudicious traction on the umbilical cord before the uterus was well contracted, was probably the most important causative factor. Haemorrhage was more severe when removal of the placenta was done prior to correction of the inversion. Either the hydrostatic method or manual replacement were used but more often a combination of both techniques was found necessary. With careful management of the third stage of labour, this complication can be avoided.
    Matched MeSH terms: Uterine Hemorrhage/therapy
  16. Japaraj RP, Raman S
    Med J Malaysia, 2003 Oct;58(4):604-7.
    PMID: 15190639
    Massive postpartum haemorrhage after Cesarean section for placenta previa is a common occurrence. The bleeding is usually from the placental bed at the lower uterine segment. Uterine tamponade has a role in the management of such patients especially when fertility is desired. We describe here a case of massive postpartum haemorrhage, which was managed, with the use of a Sengstaken-Blakemore tube. This allowed us to avoid a hysterectomy for a young primiparous patient.
    Matched MeSH terms: Postpartum Hemorrhage/therapy*
  17. Kyaw K, Raj SM
    Med J Malaysia, 1993 Sep;48(3):377-8.
    PMID: 8183158
    Matched MeSH terms: Gastrointestinal Hemorrhage/therapy*
  18. Lim TM, Lu PY, Meheshinder S, Selvindoss P, Balasingh D, Ramesh J, et al.
    Med J Malaysia, 2003 Oct;58(4):522-5.
    PMID: 15190627
    We retrospectively analyzed all patients presenting with upper gastrointestinal bleeding to Seremban Hospital over a one-year period. A quarter of the oesophagogastro-duodenoscopies (OGD) performed were performed as emergency for upper gastrointestinal tract bleeding. Gastric ulcers and duodenal ulcers were the two most common findings. Our results suggest that there is a male preponderance of 2:1, the Chinese were more likely to be affected and the elderly (> 60 years) were at highest risk.
    Matched MeSH terms: Gastrointestinal Hemorrhage/therapy
  19. McCormick A, Qasim A
    Med J Malaysia, 2005 Jul;60 Suppl B:6-11.
    PMID: 16108165
    Matched MeSH terms: Gastrointestinal Hemorrhage/therapy*
  20. Woodhull S, Bush A, Tang AL, Padley S
    Paediatr Respir Rev, 2020 Nov;36:100-105.
    PMID: 32680823 DOI: 10.1016/j.prrv.2020.06.001
    Acute, major pulmonary haemorrhage in children, is rare, may be life-threatening and at times presents atypically. Dieulafoy's disease of the bronchus presenting with recurrent or massive hemoptysis was first described in adults. Prior to reviewing the literature, we report an illustrative case of bronchial Dieulafoy's disease (BDD) in a child presenting unusually with massive apparent hematemesis. The source of bleeding is a bronchial artery that fails to taper as it terminates within the bronchial submucosa. A high index of suspicion is required to identify such lesions via radiological imaging and the role of bronchial artery embolisation is highlighted with video images of angiography included.
    Matched MeSH terms: Hemorrhage/therapy
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