MyMedR

Ataxic paraglegia occurring amongst Chinese in Malaya

Pallister RA

Trans R Soc Trop Med Hyg, 1940;34:203-211.

1. A disease occurring among Chinese in Malaya is described. The main complaints are weakness and numbness of the legs ; and the main signs absent tendon reflexes, sensory loss and ataxia.
2. The aetiology is discussed and the disease is thought to be a form of pellagra modified by other factors in the diet or circumstances of those affected.

Matched MeSH terms: Paraplegia

Urological management of paraplegic patients

Tinckler LF

Med J Malaya, 1966 Mar;20(3):205-14.

PMID: 4223071

Matched MeSH terms: Paraplegia/therapy*

The Foix-Alajouanine syndrome

Tay CH

Med J Malaya, 1971 Jun;25(4):298-300.

PMID: 4261306

Matched MeSH terms: Paraplegia

Fulltext Some experiences with non-traumatic paraplegia in Malaysia

Silva JF

Paraplegia, 1973 Aug;11(2):146-58.

PMID: 4584434 DOI: 10.1038/sc.1973.19

One hundred and forty-one patients with non-traumatic paraplegia were reviewed. The common causative factors and the problems arising were evaluated. Management of the clinical problems were described. The need for prevention and early treatment has been stressed.

Matched MeSH terms: Paraplegia/etiology*; Paraplegia/epidemiology; Paraplegia/radiography; Paraplegia/surgery

A review of patients with skeletal tuberculosis treated at the University Hospital, Kuala Lumpur

Silva JF

Int Orthop, 1980;4(2):79-81.

PMID: 7429684 DOI: 10.1007/bf00271088

Two hundred and nineteen patients with skeletal tuberculosis have been reviewed analysing the site of the lesion and the treatment given. Operative management is advocated since the results of this approach are encouraging.

Matched MeSH terms: Paraplegia/surgery

Fulltext Urodynamic evaluation of lower urinary tract function in the neurogenic bladder

Mahamooth Z, Mahamooth T, Omar A

Med J Malaysia, 1985 Jun;40(2):120-4.

PMID: 3834282

Analysis of the investigations of 14 cases of spinal injury are presented. The significance of the level of injury and the pattern of bladder function is alluded too. Some aspects of the management of neurogenic bladder are discussed.

Matched MeSH terms: Paraplegia/complications

Paraplegia

Tai KT

Family Physician, 1989;1:16-18.

Matched MeSH terms: Paraplegia

Fulltext Spinal dural arteriovenous malformation: a cause of myelopathy

Ng WK, Samad SA, Tan CT

Med J Malaysia, 1996 Mar;51(1):151-3.

PMID: 10967999

Spinal vascular malformation is an uncommon but potentially treatable cause of myelopathy. We describe two cases of angiographically proven spinal vascular malformation in Malaysia. The first case is a 47-year-old man who had a progressive myelopathy and the second a 60-year-old man with intermittent attacks of transient paraparesis leading to paraplegia. As the clinical presentation of spinal vascular malformation is variable, it should be considered as a cause of patients with myelopathy.

Matched MeSH terms: Paraplegia/etiology*

Diagenesis dan Asal Mula Dolomit dan Kuarza di dalam Batu Kapur Kodiang, Kedah (Diagenetic and Origin of Dolomite and Quartz in Kodiang Limestone, Kedah)

Che Aziz Ali, Kamal Roslan Mohamed

Sains Malaysiana, 1996;25(4):47-68.

The Kodiang Formation which outcrops in Kodiang and Alor Setar areas has been well studied and documented. Various geological aspects of the limestone formation have been reported in detail including its stratigraphy, sequence startigraphy, sedimentology and paleontology. Diagenetic aspect of this rock formation, however, had not been specifically discussed before. The Kodiang limestone has undergone a complicated diagenetic history which started immediately after the sediments were laid down on the sea bed. Various diagenetic products have been identified including, early marine cement, meteoric cement, and deeper subsurface cement. The diagenetic features identified are as follows; Fibrous calcite cement, sparry and poikilotopic calcites, calcite overgrowth, dolomite, silica cements and evaporites. Close examination at outcrops shows that dolomite occurs at several levels in the sequence. Their systematic occurrences can be correlated across the area. Petrographic studies show that dolomite occurs in several modes as stratified dolomite and as non-stratified dolomite. The two dolomite groups are attributed to two phases of dolomitizations. The stratified dolomites are interpreted to have been formed early in the limestone diagenetic history. The non-stratified dolomite type is, however, attributed to dolomitization during deep burial under the control of deeper subsurface physico-chemical conditions.
Batu Kapur Kodiang yang tersingkap di Kodiang dan Alor Setar telah banyak dikaji dan didokumentasikan. Berbagai aspek geologi formasi batu kapur ini telah dilaporkan termasuk stratigrafi, startigrafi jujukan, sedimentologi dan paleontologi. Walau bagaimanapun aspek diagenesis formasi batuan ini tidak pernah dibincangkan secara khusus. Batu kapur Kodiang ini telah melalui sejarah diagenesis yang rumit yang bermula sebaik saja sedimen dimendapkan di atas permukaan dasar laut. Berbagai hasil diagenesis telah dikenal pasti termasuk penyimenan samudera awal, penyimenan meterorik dan penyimenan di bawah permukaan yang lebih dalam. Secara asas fitur-fitur yang dikenalpasti adalah seperti berikut; simen kalsit berserat, kalsit spar dan poikilotopik, tumbuhlampau kalsit, dolomit, simen silika dan evaporit. Pemeriksaan rapi pada singkapan menunjukkan dolomit hadir pada beberapa aras di dalam jujukan. Kehadirannya secara bersistematik boleh dikorelasikan pada setiap singkapan. Kajian petrografi menunjukkan dolomit wujud dalam berbagai mod yang boleh diklaskan sebagai dolomit berstrata dan dolomit tidak berstrata. Dua klas ini boleh dikaitkan dengan dua fasa pendolomitan. Dolomit berstrata ditafsirkan telah terbentuk awal di dalam sejarah diagenesis batu kapur. Dolomit tidak berstrata pula dikaitkan dengan pendolomitan semasa timbusan dalam di bawah keadaan fiziko-kimia bawah permukaan.

Matched MeSH terms: Paraplegia

Fulltext Acute aortic occlusion: the need to be aware

Zainal AA, Oommen G, Chew LG, Yusha AW

Med J Malaysia, 2000 Mar;55(1):29-32.

PMID: 11072487 MyJurnal

A prospective study of patients with acute aortic occlusion (AAO) admitted to the Vascular Unit, Hospital Kuala Lumpur was carried out over a 12 month period. There were a total of 11 patients admitted with a clinical diagnosis of AAO. There was a male preponderance with 10 patients. The median age was 58 years (40-70 years). Hypertension was the commonest underlying medical illness (n = 7). All patients had painful lower limb paraparesis or paraplegia with bilateral absent limb pulses from the groin downwards on admission to the vascular unit. The majority of patients (10 patients) were referred from other hospitals, of which 6 patients came from outside the Klang Valley. Only eight (8) patients underwent an operative procedure with seven (7) having an initial bilateral balloon catheter thromboembolectomy. There was one (1) aorta-bifemoral bypass after failed embolectomy. An aneurysectomy with inlay-graft was done as the initial procedure in one (1) patient. Mortality was 82% (9/11). The two survivors were in the group that had vascular reconstructive surgery. Acute aortic occlusion is an uncommon but catastrophic event with a high mortality. Clinicians must have a high index of suspicion in patients who present with painful paresis or paraplegia. Clinical examination of peripheral pulses in these patients is mandatory. Early diagnosis and treatment is important to improve the outcome of this disease.

Matched MeSH terms: Paraplegia/etiology*; Paraplegia/physiopathology

Fulltext Traumatic posterior rotatory fracture-dislocation of lumbo-sacral spine

Mukundala VV, Lim HH

Singapore Med J, 2001 Feb;42(2):82-4.

PMID: 11358198

Fracture-dislocation of the lumbo-sacral spine was an unusual injury and was divided into anterior, posterior and lateral types depending on the displacement of the cephalad portion of the spine over the caudal portion. According to the authors' knowledge, only 31 cases of traumatic fracture-dislocation of the lumbo-sacral spine were reported in the English literature. Only 3 previous reports referred to this injury with a posterior displacement, which was an even rarer injury. This was the fourth report of this type of injury.

Matched MeSH terms: Paraplegia/etiology

Fulltext Predictive factors in the evolution of neural deficit in tuberculosis of the spine

Tan SC, Harwant S, Selvakumar K, Kareem BA

Med J Malaysia, 2001 Jun;56 Suppl C:46-51.

PMID: 11814249 MyJurnal

This study was conducted to determine the factors involved in predicting the onset of paraplegia in tuberculosis of the spine. A cross-sectional, case control review of 85 cases of spinal tuberculosis was conducted at the National Tuberculosis Centre in Kuala Lumpur. Sixty-nine of these cases were normal neurologically, whilst 16 cases experienced neural deficit. The data was analysed using backward logistic regression and Fishers exact probability test. The factors studied included symptoms and signs of spinal tuberculosis, common investigations for tuberculosis, and physical factors of the disease. Only the erythrocyte sedimentation rate (ESR) showed a significant difference between the neural deficit and neurologically normal groups. This suggests that the ESR may be a factor in predicting evolution of paraplegia in spinal tuberculosis. In addition, it was noted that a low proportion of patients had positive sputum smear results and bacterial culture growth for mycobacterium tuberculosis suggesting these tests are of limited value for tuberculosis of the spine.

Matched MeSH terms: Paraplegia/etiology*

Fulltext Intercostal nerve neurotization of the femoral nerve in patients with paraplegia--an anatomical feasibility study

Lim HH, Baskaran

Med J Malaysia, 2001 Jun;56 Suppl C:61-5.

PMID: 11814252

Neurotization of the brachial plexus is an established procedure in the upper limb. However, neurotization of the lower limb remains experimental. Brunelli reported the use of the ulnar nerve to neurotize the lower limb. Zhao et al reported the use of intercostals nerve to neurotize the lower limb in rats. The aim of the study was to determine the feasibility of using intercostals nerve to neurotize the femoral nerve in human cadavers and to ascertain the ideal intercostals nerve that has the anatomical course that suit this role. Six fresh cadaveric dissection were performed through an extensile midline incision in the postmortem room and the lower six (T7-T12) were identified and traced from their origin. Their length and course identified and charted. T9 and T10 intercostal nerve was thought to be the most suitable nerve as the donor nerve, and the T11 and T12 intercostal nerve could not be free from its intra-muscular course sufficiently to be use as donor.

Matched MeSH terms: Paraplegia/pathology*; Paraplegia/surgery*

Fulltext Clinical profile of acute flaccid paralysis

Rasul CH, Das PL, Alam S, Ahmed S, Ahmed M

Med J Malaysia, 2002 Mar;57(1):61-5.

PMID: 14569719

This study was done to determine the clinical course, cause and outcome of Acute Flaccid Paralysis (AFP) in children. All AFP cases (< 15 years) in the children's ward of Khulna Medical College Hospital (Bangladesh) were recorded, investigated and followed up to sixty days as a part of passive surveillance. Main outcome variables were vulnerable age group, vaccine status, predominant limb involvement, clinical variants, virus isolation and residual paralysis. Thirty-four children with AFP were admitted in hospital in the last three years with the highest number (14) in 1998. The majority of children belonged to the age group 5-9 years with a male female ratio of 1.3:1. Nearly one third of the cases were either partially vaccinated or not vaccinated at all. The lower limbs bore the brunt of paralysis excepting a few (14.7%). Clinically, Guillain Barre Syndrome was the commonest (47.1%) followed by encephalomyelitis. No poliovirus was isolated from these cases. Residual paralysis was observed in four out of ten cases who returned for follow up. AFP will continue to occur even after eradication of poliomyelitis and Guillain Barre Syndrome is the most important clinical entity for this.

Matched MeSH terms: Paraplegia/etiology*; Paraplegia/physiopathology*; Paraplegia/therapy

Fulltext Tuberculous paraplegia in pregnancy treated by surgery

Singh H, Singh J, Abdullah BT, Matthews A

Singapore Med J, 2002 May;43(5):251-3.

PMID: 12188078

Tuberculous paraplegia in pregnancy is reported to be rare. Paraplegia due to tuberculosis has a good prognosis if surgical decompression and stabilisation are done early together with chemotherapy. Vaginal delivery is not contraindicated in pregnancy complicated by paraplegia, but is associated with problems related to the initiation and progression of labour. Performing spinal nursing on an unstable spine with a rapidly enlarging gravid uterus in the third trimester of pregnancy poses a significant challenge. We report successful simultaneous Caesarean section and surgical treatment of a paraplegic spine due to tuberculosis.

Matched MeSH terms: Paraplegia/etiology; Paraplegia/surgery*

Adenovirus type 21-associated acute flaccid paralysis during an outbreak of hand-foot-and-mouth disease in Sarawak, Malaysia

Ooi MH, Wong SC, Clear D, Perera D, Krishnan S, Preston T, et al.

Clin Infect Dis, 2003 Mar 1;36(5):550-9.

PMID: 12594634

We report the virological and clinical features of 8 children who presented with adenovirus-associated acute flaccid paralysis (AFP) during an epidemic of enterovirus type 71 (EV71)-associated hand-foot-and-mouth disease (HFMD) in Sarawak, Malaysia, in 1997. Neutralization tests and phylogenetic analysis revealed adenovirus type 21 (Ad21), although DNA restriction digests suggested that this virus was different from the prototype Ad21. Four children had upper-limb monoparesis, 2 had lower-limb monoparesis (one of whom had changes in the anterior spinal cord noted on magnetic resonance imaging), and 2 had flaccid paraparesis. At follow-up, 4 children were noted to have made full recoveries and 3 had residual flaccid weakness and wasting. Neurophysiological investigation revealed a mixture of axonal and demyelinating features in motor and sensory nerves, with denervation. These findings suggest that Ad21 might cause AFP by anterior horn cell damage or neuropathy of the brachial or lumbosacral plexus. The occurrence of these unusual adenovirus infections during an outbreak of EV71-associated HFMD suggests that an interaction between the 2 viruses may have occurred.

Matched MeSH terms: Paraplegia/complications; Paraplegia/immunology; Paraplegia/virology*

Five-year surveillance of acute flaccid paralysis in Malaysia

Hussain IH, Ali S, Sinniah M, Kurup D, Khoo TB, Thomas TG, et al.

J Paediatr Child Health, 2004 Mar;40(3):127-30.

PMID: 15009577

OBJECTIVE: The nation-wide surveillance for acute flaccid paralysis (AFP) was implemented in Malaysia in 1995 and further intensified in 1996 as part of the World Health Organization's (WHO) certification process for polio eradication in the Western Pacific Region. Clinical data on AFP cases during a 5-year surveillance period from 1997 to 2001 were compiled and analysed.

RESULTS: Based on 517 cases of AFP reported during this 5-year period, the overall rate of AFP was 1.2 per 100 000 children below 15 years old. The major clinical diagnosis associated with AFP were Guillain-Barre syndrome (30.2%), central nervous system infection (16.2%), transverse myelitis (10.6%) non-polio enterovirus infection (6.2%), and hypokalaemic paralysis (5.2%). This unusual pattern with an excess of CNS infection and non-polio enterovirus infection was attributed to the outbreak of enterovirus 71 infection nation-wide in 1997. According to the WHO virological classification, there was no case of poliomyelitis due to wild poliovirus. Three cases were 'polio compatible', there were no cases of vaccine-associated paralytic polio (VAPP), while 62 cases (12.0%) were merely classified as 'non-polio AFP'.

CONCLUSION: Overall, these data suggest the absence of circulation of wild poliovirus in Malaysia from 1997 to 2001. The pattern of AFP in this study is different from other published reports.

Matched MeSH terms: Paraplegia/epidemiology*

Fulltext Laboratory acute flaccid paralysis surveillance in Malaysia: a decade of commitment to the WHO global polio eradication initiative

Saraswathy TS, Khairullah NS, Sinniah M, Fauziah MK, Apandi MY, Shamsuddin M

Southeast Asian J. Trop. Med. Public Health, 2004 Jun;35(2):421-4.

PMID: 15691149

The Institute for Medical Research, Malaysia, was designated the National Reference Laboratory for Poliomyelitis Eradication (NRLPE) in 1992. Since then, our Polio Laboratory has collaborated actively with the Disease Control Division, Ministry of Health (MOH), Malaysia and WHO towards achieving polio eradication. Since 1992, the NRLPE has investigated 1,063 stool specimens from 641 acute flaccidparalysis (AFP) cases. One hundred and one enteroviruses were isolated from these specimens. Positive cell cultures were confirmed by microneutralization assay using standard WHO antisera. All enterovirus isolates were sent to the Victorian Infectious Disease Reference Laboratory in Melbourne, Australia, for further identification and poliovirus intratypic differentiation. Thirty-one out of these 101 virus isolates (30%) were polioviruses (PV) and the remaining 70 (70%) were non-polio enteroviruses (NPEV) which included coxsackie B viruses, echoviruses and enterovirus 71. Three of the poliovirus isolates were wild-type polioviruses isolated in 1992 which were the last wild-type polioviruses isolated in Malaysia. The rest were vaccine-related Sabin-like strains. Monthly reports of the virological investigation of AFP cases are sent to WHO and to the MOH, AFP control committee. The NRLPE continues to play an integral role in AFP surveillance and is committed to the WHO's goal of global polio eradication by the year 2005.

Matched MeSH terms: Paraplegia/epidemiology; Paraplegia/prevention & control*; Paraplegia/virology

Spinal pseudomeningocoele: a diagnostic dilemma

Julia PE, Nazirah H

Spinal Cord, 2007 Dec;45(12):804-5.

PMID: 17710102

Case report.

Matched MeSH terms: Paraplegia/complications; Paraplegia/pathology

Fulltext Acute flaccid paralysis surveillance: looking beyond the global poliomyelitis eradication initiative

Saraswathy TS, Zahrin HN, Apandi MY, Kurup D, Rohani J, Zainah S, et al.

Southeast Asian J. Trop. Med. Public Health, 2008 Nov;39(6):1033-9.

PMID: 19062691

In 1992 surveillance of acute flaccid paralysis (AFP) cases was introduced in Malaysia along with the establishment of a national referral laboratory at the Institute for Medical Research. The objective of this study was to determine the incidence, viral etiology and clinical picture of AFP cases below 15 years of age, reported from 2002 to 2007. Six hundred seventy-eight of 688 reported cases were confirmed as AFP by expert review. The clinical presentation of acute flaccid paralysis in these cases was diverse, the most commonly reported being Guillian-Barre syndrome (32.3%). Sixty-nine viruses were isolated in this study. They were Sabin poliovirus (25), Echovirus (22), Cocksackie B (11), EV71 (5), Cocksackie A (1), and untypable (5). Malaysia has been confirmed as free from wild polio since the surveillance was established.

Matched MeSH terms: Paraplegia/etiology; Paraplegia/epidemiology*; Paraplegia/virology*

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