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  1. Fulltext "Two Stones on One Bird": A Case Report on Severe Biphasic Anaphylaxis Masquerading as Life-Threatening Acute Asthma
    Payus AO, Ibrahim A, Mustafa N
    Open Access Maced J Med Sci, 2018 Nov 25;6(11):2136-2138.
    PMID: 30559876 DOI: 10.3889/oamjms.2018.317
    BACKGROUND: Anaphylaxis often misdiagnosed and treated as acute asthma, especially when it has a predominant respiratory symptom, and there are no obvious precipitants or previous allergic history. This morbid outcome is preventable if the level of suspicion for anaphylaxis is high among healthcare provider when treating a patient who is not responding to the standard management of acute asthma. A proportion of anaphylactic patient shows a biphasic reaction which potentially fatal when it is under-anticipated and prematurely discharge without adequate observation period after the recovery of the initial episode.

    CASE REPORT: Here, we present a case of a young man who has childhood asthma with the last attack more than 10 years ago presented with symptoms suggestive of acute exacerbation of bronchial asthma. As the symptoms failed to improve after standard asthma management, anaphylaxis was suspected, and he was given intramuscular adrenaline 0.5 mg which leads to symptom improvement. However, he developed another attack shortly after improvement while under observation.

    CONCLUSION: The objective of this case report is to emphasise the importance of keeping anaphylaxis in mind whenever a patient has treatment-refractory asthma, and also the anticipation of biphasic reaction that warrants adequate observation period especially those who are likely to have developed it.

    Matched MeSH terms: Morbidity
  2. A Case of Paraganglioma with Cyanotic Congenital Heart Disease
    Wahab NA, Chien BH, Omar MR, Aziz AA, Mustafa N, Sukor N, et al.
    Acta Med Indones, 2021 Jan;53(1):77-81.
    PMID: 33818409
    Co-occurrence of cyanotic congenital heart disease (CCHD) and phaeochromocytoma (PCC) and paraganglioma (PGL) are rare, although some cases have been reported. We report a case of left paraganglioma in a 20-year-old lady with an underlying CCHD who underwent palliative Glenn shunt, subsequently developed polycythaemia and cavernous sinus thrombosis presented with palpitation, sweating, headache and hypertension of 3-months duration at the age of 17. The abdominal CT scan revealed an enhancing left paraaortic mass measuring 5.2 cm x 4.4 cm x 3.8 cm. A 24-hour urine catecholamine demonstrated raised noradrenaline level to six times upper limit of normal and hence diagnosis of left sympathetic (sPGL) was made. In view of the delayed diagnosis and significant morbidity associated with her condition, surgical treatment is no longer an option. Therefore, vigilant screening and early treatment of PCC-PGL in patients with CCHD are crucial in order to avoid significant morbidity and ensure a good quality of life.
    Matched MeSH terms: Morbidity
  3. Fulltext A Review of Guidelines to Resuming Elective Orthopaedic Surgeries Amid COVID-19 Pandemic: Deriving a Simple Traffic Light Model
    Attia AK, Omar UF, Kaliya-Perumal AK
    Malays Orthop J, 2020 Nov;14(3):10-15.
    PMID: 33403057 DOI: 10.5704/MOJ.2011.003
    The COVID-19 pandemic has affected most healthcare systems around the world. Routine care operations such as outpatient clinics and elective surgery remain badly hit. This situation cannot continue for long as it puts patients at a higher risk for complications due to delayed management. Hence, it is essential to resume routine, especially elective surgery. Regarding orthopaedic practice, various authors and organisations have come out with guidelines to resume elective surgeries. However, clear consensus and common strategies need be derived. With this motive, we conducted a review of the literature for guidelines to resume elective orthopaedic surgery amid COVID-19 pandemic and shortlisted scholarly publications and information from regional organisations. We have summarised the information and derived an organised algorithm considering the guidelines provided by various sources. In this extraordinary time, guidelines come in as a relief for every surgeon who is in a dilemma whether to resume electives or not. Putting safety first, these guidelines or suitable versions should be followed at all levels wherever possible to avoid the lack of trained manpower in the event of staff morbidity.
    Matched MeSH terms: Morbidity
  4. Fulltext A comparison of morbidity patterns in Peninsular Malaysia 1959 and 1974
    Arokiasamy JT, Chen PCY
    Med J Malaysia, 1980 Jun;34(4):336-42.
    PMID: 7219259
    Disease patterns among outpatients seen at static and travelling dispensaries, as well as among hospital admissions and hospital deaths are compared between 1959 and 1974. While disease patterns of patients seen by travelling dispensaries show no change, patients seen by static dispensaries and hospital admissions in 1974 show a marked relative decline in infective and parasitic diseases and an increase in accidents, poisonings and violence. Causes of death in hospitals in 1974 were different, there being relative increases in diseases of early infancy, diseases of circulatory system, neoplasms, and accidents, poisonings, violence while infective and parasitic diseases, and diseases of the digestive system declined.
    Matched MeSH terms: Morbidity*
  5. Fulltext A comparison of morbidity patterns in public and private primary care clinics in malaysia
    Mimi O, Tong SF, Nordin S, Teng CL, Khoo EM, Abdul-Rahman A, et al.
    Malays Fam Physician, 2011;6(1):19-25.
    PMID: 25606215 MyJurnal
    OBJECTIVES: To compare the morbidity patterns in public and private primary care clinics; determine patients' reasons for encounter (RFE) and diagnoses using the ICPC-2, and compare ten commonest diagnoses and RFEs.
    METHODS: A cross-sectional study on randomly selected clinics was conducted nationwide. Doctors completed the Patient Encounter Record (PER) for systematically selected encounters for a week.
    RESULTS: Response rate was 82.0% (public clinic) and 33% (private clinic) with 4262 encounters and 7280 RFE. Overall, the three commonest disease categories encountered were respiratory (37.2%), general and unspecified (29.5%), and cardiovascular diseases (22.2%). Public and private clinics handled 27% versus 50% acute cases and 20.0% versus 3.1% chronic cases i.e. 33.7 and 5.6 chronic diseases per 100 RFE respectively.
    CONCLUSION: Doctors in public clinics saw more chronic and complex diseases as well as pregnancy related complaints and follow-up cases while in private clinics more acute and minor illnesses were seen. Health services should be integrated and support given to co-manage chronic diseases in both sectors.
    KEYWORDS: Malaysia; Primary practice; delivery of health care; morbidity pattern; reasons for encounter
    Matched MeSH terms: Morbidity*
  6. Fulltext A cross-sectional study of the prevalence, density, and risk factors associated with malaria transmission in urban communities of Ibadan, Southwestern Nigeria
    Awosolu OB, Yahaya ZS, Farah Haziqah MT, Simon-Oke IA, Fakunle C
    Heliyon, 2021 Jan;7(1):e05975.
    PMID: 33521357 DOI: 10.1016/j.heliyon.2021.e05975
    Background: Malaria is a severe global public health challenge that causes significant morbidity and mortality worldwide, particularly in sub-Saharan Africa. This study was designed to determine the prevalence, parasite density, and risk factors associated with malaria infection transmission among residents of two urban communities of Ibadan, southwestern Nigeria.

    Materials and methods: A cross-sectional hospital-based study was carried out on 300 participants. Blood samples were obtained. Thick and thin blood films were prepared and viewed using the standard parasitological technique of microscopy. Moreover, data on sociodemographic and environmental variables were obtained using a pre-tested standard questionnaire.

    Results: Of the 300 participants examined, a total of 165 (55.0%) were found positive for Plasmodium falciparum with a mean (S.D) parasite density of 1814.70 (1829.117) parasite/μL of blood. The prevalence and parasite density of malaria infection vary significantly (P < 0.05) with age group. Children <5 years old were more likely to have malaria infection and high parasite densities than adults (p < 0.05). Similarly, in relation to gender, males significantly (P < 0.05) had a higher prevalence (60.2%) and mean (S.D) parasite density of malaria infection [2157.73 (1659.570) parasite/μL of blood] compared to females. Additionally, those without formal education had the highest prevalence (73.0%) and mean (S.D) parasite density of infection [2626.96 (2442.195) parasite/μL of blood]. The bivariate logistic regression analysis shows that age group 6-10 (Crude Odds Ratio, COR 0.066, 95% CI: 0.007-0.635), presence of streams/rivers (COR 0.225, 95% CI: 0.103-0.492), distance from streams/rivers within ≤1 km (COR 0.283, 95% CI: 0.122-0.654) and travel to rural area (COR 4.689, 95% CI: 2.430-9.049) were the significant risk factors.

    Conclusions: Malaria infection is prevalent in the study area and was greatly influenced by traveling activities from the rural areas to urban centers and vice versa. Multifaceted and integrated control strategy should be adopted. Health education on mosquito prevention and chemoprophylaxis before and during travel to rural areas are essential.

    Matched MeSH terms: Morbidity
  7. Fulltext A descriptive study of decompression illness among scuba divers treated with hyperbaric oxygen therapy at a military hospital-based recompression facility in Peninsular Malaysia
    Fazriyati Jamharee, Abu Yazid Md Noh, Tuan Hairulnizam Tuan Kamauzaman, Ariff Arithra Abdullah, Junainah Nor
    Malaysian Journal of Emergency Medicine, 2016;1(1):11-23.
    MyJurnal
    Background: Diving related illness has become a public health concern, as there isan increasing number of diversworldwide. However, the incidence of Decompression Illness (DCI), a medical disorder as a result of sudden reduction of ambient pressure, remainsgenerallylow. This paper describes the patternsof decompression illness treated in a military hospital-based recompression chamber facility in Peninsular Malaysiafrom year 2000 until 2010.Objective:The objective ofthis study is to determine the patternsof decompression illnesspatientstreated withHyperbaric Oxygen Therapy(HBOT)in a military hospital-based recompression chamber facility inPeninsular Malaysia.
    Methodology:A retrospective descriptive study was carried out to utilizesecondary data from Hospital Angkatan Tentera Lumut, Perakfrom 1stJanuary 2000 to 31stDecember 2010. A total of 96 caseswere included in thisstudy.
    Results:Most of the patients were male (94.8%), recreational divers (43.0%), non-smokers (56.3%),with no previous medical illness(85.4%), who had dived with compressed air (78.0%), had lessthan 5years divingexperience (56.3%), were non-instructors(75.0%),and had body mass index between 18.5 to 24.9kg/m2(59.4%). Interestingly,25% of the patients developing DCI dived to less than 10 meters depth, 35.4% of them went for a single dive and 71.9% performed safety stops.The majority of the patients had symptoms startingwithin 12 hours after surfacing (85.4%),mainly within the first 3 hours and many had neurological manifestation (61.5%).Only 16.7% of the patients treated withHBOThad therapycommenced within 6 hours from the onset of symptomsand 93.8% from this group had complete recovery. Overall,76.0% of patients had fullrecovery after HBOT.
    Conclusion:Diving activities must be closely monitored. Medical surveillance as well as legislations related to diving activities in Malaysia areessential to improve SCUBA discipline and to reduce mortality and morbidity ofDCI in the future.
    Matched MeSH terms: Morbidity
  8. Fulltext A five-year retrospective review of snakebite patients admitted to a tertiary university hospital in Malaysia
    Chew KS, Khor HW, Ahmad R, Rahman NH
    Int J Emerg Med, 2011;4:41.
    PMID: 21752254 DOI: 10.1186/1865-1380-4-41
    Although the majority of the snakebite cases in Malaysia are due to non-venomous snakes, venomous bites cause significant morbidity and mortality if treatment measures, especially ant-venom therapy, are delayed.
    Matched MeSH terms: Morbidity
  9. A longitudinal study of age-related changes in intraocular pressure: the Kangbuk Samsung Health Study
    Zhao D, Kim MH, Pastor-Barriuso R, Chang Y, Ryu S, Zhang Y, et al.
    Invest Ophthalmol Vis Sci, 2014 Oct;55(10):6244-50.
    PMID: 25183763 DOI: 10.1167/iovs.14-14151
    To examine the longitudinal association between age and intraocular pressure (IOP) in a large sample of Korean men and women.
    Matched MeSH terms: Morbidity/trends
  10. Fulltext A pilot study of enhance recovery after surgery (ERAS) for liver resection
    Jarmin, R., Othman, H., Zuhdi, Z., Mohamad, I.S., Ahmad, A.W., Ariffin, A.C.
    International Medical Journal Malaysia, 2017;16(2):41-45.
    MyJurnal
    Background: Morbidity post hepatectomy still remain persistent throughout decades compared to other
    surgery. Modern approach have been introduced to improve safety and reduce morbidity whilst at the same
    time enhance patient recovery. Thus, enhanced recovery after surgery or fast track recovery program for
    liver resection was initiated.

    Objective: The aim of this study was to achieve discharge by postoperative
    day 3 for minor resection and day 5 for major resection.

    Design and Setting: This is a prospective study
    conducted in Hospital Universiti Kebangsaan Malaysia (HUKM) from September 2014 till April 2015.

    Material
    and Methods: All patients undergoing open liver resection were included in the study. They were then
    managed post operatively according to ERAS protocol that was drawn up based on previous studies. Patient’s
    demographics data, intra operative parameters, postoperative complications and adherence to
    postoperative recovery protocol were recorded.

    Results: Seventeen patients (7 major and 10 minor
    resection) were recruited. The mean length of hospital stay for minor resection was 5.9 and major resection
    was 9.6 .With regards to the targets, 4 out of 10 (40%)patients in minor resection group and 4 out 7 (57.1%)
    in the major group were discharged on time. 9 patients had postoperative complications with no mortality
    recorded. In terms of the ERAS protocol targets, the PCA morphine discontinuation target was achieved in
    15 patients (88.3%) ,nasogastric tube removal (13 patients -76.5%) , urinary cathether removal (6 patients -
    35.3%), abdominal drains removal (9 patients-52.9%) and resumption of full diet was achieved by 82.4% (14
    patients).

    Conclusion: From these overall achievement, most of our targets have been met and this shows
    that our ERAS protocol is safe to be applied to patient undergoing hepatectomy.

    Limitations: Some patients
    had achieved their target but not discharged for unknown reason.
    Matched MeSH terms: Morbidity
  11. Fulltext A review of dengue research in Malaysia
    Cheah WK, Ng KS, Marzilawati AR, Lum LC
    Med J Malaysia, 2014 Aug;69 Suppl A:59-67.
    PMID: 25417953 MyJurnal
    Dengue infection is a major cause of morbidity and mortality in Malaysia. To date, much research on dengue infection conducted in Malaysia have been published. One hundred and sixty six articles related to dengue in Malaysia were found from a search through a database dedicated to indexing all original data relevant to medicine published between the years 2000-2013. Ninety articles with clinical relevance and future research implications were selected and reviewed. These papers showed evidence of an exponential increase in the disease epidemic and a varying pattern of prevalent dengue serotypes at different times. The early febrile phase of dengue infection consist of an undifferentiated fever. Clinical suspicion and ability to identify patients at risk of severe dengue infection is important. Treatment of dengue infection involves judicious use of volume expander and supportive care. Potential future research areas are discussed to narrow our current knowledge gaps on dengue infection.
    Matched MeSH terms: Morbidity
  12. Fulltext A study of the place of deliveries in Terengganu 1999. [Kajian pilihan tempat bersalin di Negeri Terengganu 1999]
    Nordiyanah Hassan
    Malaysian Journal of Public Health Medicine, 2002;2(2):63-70.
    MyJurnal
    The number of deliveries increased very signdicantly in all hospitals in Terengganu since 1986. It is in line with the promotion of Safe Motherhood Initiative' with the aim to reduce maternal mortality and morbidity in a Terengganu. The aim of the study was to determine the pattern of choice for place of deliveries by local people in Terengganu and also to identdy risk factors related to their place of choice. A total of 9741 deliveries home January 1999 to 30”’ of June 1999 were included in the study. About 46% delivered in Hospital Kuala Terengganu, where 72% of them were high-risk mothers. Whereas deliveries in the district hospitals were 9.9% in Kemaman Hospital, 9.7% in Besut Hospital, 7.2% in Dungun Hospital and 3.4% in Hulu Terengganu Hospital. About 67% of district hospital deliveries were high-risk mothers. Only 12.4% of deliveries were home deliveries, however 49% of them were high-risk mothers. Utilization of alternative birthing centre in health clinics was only 1.7%. The study revealed that mothers’ risk factors are the factors signaicantly influence the place of choice for deliveries. The study jindings call for an urgent need of three essential services, Firstly an urban birthing centre conducted by obstetrician or the medical ojicers to be developed at the vicinity of the present general hospital to cater for the high percentage of high—risk pregnancies in the state. Secondly, all or selected district hospital to be given post for obstetrician, and thirdly it is a need to evaluate the current ‘High Risk Checklist for Antenatal Mothers’ to ensure treatment priority is indeed given to those really in need based on appropriate risk factors.
    Matched MeSH terms: Morbidity
  13. A successful pregnancy outcome of homozygous familial hypercholesterolaemia patient on statin therapy
    Mohd Kasim NA, Al-Khateeb A, Chua YA, Sanusi AR, Mohd Nawawi H
    Malays J Pathol, 2021 Apr;43(1):87-93.
    PMID: 33903311
    Homozygous familial hypercholesterolaemia (HoFH) is a rare genetic disorder of lipoprotein metabolism mainly due to mutation of the low-density lipoprotein (LDL)-receptor gene (LDLR). It is a life-threatening disease that causes accelerated, multi-vessel atherosclerosis presented in early childhood. Pregnancy in HoFH may pose early coronary morbidity and mortality to both the foetus and mother. The combination of HoFH and pregnancy can be a fatal condition. While statins are very effective in lowering low-density lipoprotein cholesterol (LDL-C) levels, they are generally contraindicated during pregnancy, thus their use during pregnancy is uncommon. On the other hand, lipid apheresis (LA) has turned into an effective treatment to control cholesterol level amid pregnancy. However, the procedure is not widely available in our region. To date, there are scarcely documented case reports of HoFH in pregnancy in which the majority of them underwent LA to keep LDL-C at a low level. We report a rare case of successful pregnancy outcome of HoFH patient treated with lipid-lowering drugs including statin without LA therapy. Apart from that, we also discussed the genetic findings of the proband and all screened family members in which to the best of our knowledge, the first study using the whole-exome sequencing technique to identify the causative gene mutations for familial hypercholesterolaemia among the Malaysian population.
    Matched MeSH terms: Morbidity
  14. Fulltext A survey of mothers' knowledge about childhood diarrhoea and its management among a marginalised community of Morang, Nepal
    Mukhtar A, Mohamed Izham MI, Pathiyil RS
    Australas Med J, 2011;4(9):474-9.
    PMID: 23393537 DOI: 10.4066/AMJ.2011.821
    Diarrhoea, a common disease, is one of the major determinants of childhood morbidity and mortality in Nepal.
    Matched MeSH terms: Morbidity
  15. Fulltext Abdominal Obesity in Malaysian Adults: National Health and Morbidity Survey III (NHMS III, 2006)
    Kee CC, Jamaiyah H, Noor Safiza MN, Khor GL, Suzana S, Jamalludin AR, et al.
    Malays J Nutr, 2008 Sep;14(2):125-35.
    PMID: 22691770 MyJurnal
    Abdominal obesity (AO) is an independent risk factor for cardiovascular disease, hypertension and diabetes mellitus in adults. There is a lack of data on the magnitude and socio-demographic profile of AO among Malaysian adults at the national level. In the Third National Health and Morbidity Survey (NHMS III) conducted in 2006, AO of adults aged 18 years and above was determined based on the waist circumference as part of the nutritional status assessment. This article reports the prevalence of AO in relation to socio-economic factors and demographic characteristics of adult subjects. Out of a total of 33,465 eligible individuals 18 years and above, waist circumference was measured in 32,900 (98.3%) individuals. The prevalence of AO was assessed using the cut-off points recommended by World Health Organization. The mean waist circumference in men and women was 84.0cm [95% confidence interval (95% CI): 83.8, 84.3] and 80.3cm (95% CI: 80.1, 80.6) respectively. The national prevalence of AO was 17.4% (95% CI: 16.9, 17.9). The identified risks of AO were women (OR: 4.2, 95% CI: 3.8, 4.6), aged 50-59 years (OR: 5.6, 95% CI: 4.0, 7.7), Indians (OR: 3.0, 95% CI: 2.4, 3.8), housewives (OR: 1.4, 95% CI: 1.1, 1.7), subjects with primary education (OR: 1.3, 95% CI: 1.1, 1.5) and ever married (OR: 1.4, 95% CI: 1.2, 1.6). Being the largest population-based study on AO among Malaysians, these findings have important public health implications. There is an urgent need to revise public health policies and programmes aimed at prevention of abdominal obesity especially in the groups at risk.
    Study name: National Health and Morbidity Survey (NHMS-2006)
    Matched MeSH terms: Morbidity
  16. Fulltext Absence of antiretroviral therapy and other risk factors for morbidity and mortality in Malaysian compulsory drug detention and rehabilitation centers
    Fu JJ, Bazazi AR, Altice FL, Mohamed MN, Kamarulzaman A
    PLoS One, 2012;7(9):e44249.
    PMID: 23028508 DOI: 10.1371/journal.pone.0044249
    Throughout Asia, people who use drugs are confined in facilities referred to as compulsory drug detention and rehabilitation centers. The limited transparency and accessibility of these centers has posed a significant challenge to evaluating detainees and detention conditions directly. Despite HIV being highly prevalent in this type of confined setting, direct evaluation of detainees with HIV and their access to medical care has yet to be reported in the literature.
    Matched MeSH terms: Morbidity
  17. Fulltext Acute coronary syndrome in young adults from a Malaysian tertiary care centre
    Hoo FK, Foo YL, Lim SM, Ching SM, Boo YL
    Pak J Med Sci, 2016 Jul-Aug;32(4):841-845.
    PMID: 27648025
    Acute coronary syndrome (ACS) is one of the leading cause of morbidity and mortality worldwide. It is relatively uncommon in young adults as compared to the older population. Our objective was to assess the prevalence, demographic distribution, and risk factors for acute coronary syndrome (ACS) in patients less than 45 years of age admitted to a Malaysian tertiary care centre.
    Matched MeSH terms: Morbidity
  18. Fulltext Acute necrotizing encephalopathy of childhood: a severe case with fatal outcome
    Yee Lin Lee, Hasyma Abu Hassan, Intan Hakimah Ismail
    Malaysian Journal of Medicine and Health Sciences, 2020;16(2):323-325.
    MyJurnal
    Acute necrotizing encephalopathy of childhood (ANEC) is a rare condition which is important for clinicians to recognize as it has a high mortality rate and can result in significant neurological morbidities. It presents as acute encephalopathy with radiological findings of symmetrical brain lesions in bilateral thalami, putamen, brain stem teg- mentum, internal capsule, periventricular white matter and cerebellar medulla. Intravenous methylprednisolone is the mainstay of treatment. Immunoglobulin therapy and therapeutic hypothermia may be used as adjunctive therapy in cases with severe clinical and neuroradiological presentation. We present a case of severe ANEC and discuss the clinical manifestations, neuroimaging and management options.
    Matched MeSH terms: Morbidity
  19. Admission hypothermia among VLBW infants in Malaysian NICUs
    Boo NY, Guat-Sim Cheah I, Malaysian National Neonatal Registry
    J Trop Pediatr, 2013 Dec;59(6):447-52.
    PMID: 23774951 DOI: 10.1093/tropej/fmt051
    This study aimed to determine the prevalence of admission hypothermia (AH) among very-low-birth-weight (≤1500 g) infants in 32 Malaysian neonatal intensive care units (NICUs). This was a retrospective analysis of prospectively collected data of all very-low-birth-weight infants admitted and a questionnaire survey of the practice of AH prevention. Of the 3768 (99.8%) infants with admission temperature recorded, 64.8% (n = 2440) were hypothermic: 40.3% (n = 983) mildly (36.0-36.4°C), 58.5% (n = 1428) moderately (32.0-35.9°C) and 1.2% (n = 29) severely (<32.0°C). Mean ambient temperature of these NICUs was 22.8°C (SD = 2.7, n = 28) in labour rooms and 20.1°C (SD = 1.6, n = 30) in operation theatres. None of the NICUs practised complete care bundle against AH at birth (i.e. use of pre-warmed radiant warmer and cling wrap, ambient temperature of at least 25°C and use of pre-warmed transport incubator). Care bundle against neonatal hypothermia should be actively promoted in Malaysian labour rooms and operation theatres.
    Matched MeSH terms: Morbidity
  20. Adolescent Health Risk Behaviors and Mental Health: Evidence From the Malaysian National Health and Morbidity Survey 2017
    Othman S, A Essau C
    Asia Pac J Public Health, 2019 11;31(8_suppl):6S-7S.
    PMID: 31747779 DOI: 10.1177/1010539519887322
    Study name: National Health and Morbidity Survey (NHMS-2017)
    Matched MeSH terms: Morbidity
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