Displaying publications 1 - 20 of 90 in total

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  1. Fulltext A Descriptive Study of Blood Films of Patients Serologically Positive for Dengue in Hospital Tengku Ampuan Afzan, Kuantan.
    Rusmawati, I., Asma Hanim, H., Naznin, M., Salman, M.S., Norlelawati, A.T.
    International Medical Journal Malaysia, 2010;9(2):35-37.
    MyJurnal
    Introduction: Dengue is one of the commonest infections in Malaysia and it is a notifi able disease. Even
    though the diagnosis of classical dengue fever and dengue haemorrhagic fever can be recognized clinically, the diagnosis remains a challenge in areas where it could not be differentiated with other febrile illnesses. The aim of this study was to focus on the specifi c and consistent morphological features observed in blood fi lms of dengue infection. Materials and Methods: In all 400 cases of dengue infection serologically diagnosed in the Tengku Ampuan Afzan Hospital (HTAA) during May to October 2007, only a total of 27 cases had blood fi lms examined, and thus were included in this study. These blood fi lms were re-examined by two pathologists from HTAA. The full blood count parameters were also retrieved and studied. Results: We consistently found typical reactive lymphocytes [n= 23 (85%)] and thrombocytopenia [n=21, (77.8%)] in the cases. However, leucopenia was present only in 9 cases (33%). Conclusion: The presence of typical reactive lymphocyte is a consistent fi nding in dengue fever and thus could have a signifi cant role in supporting the diagnosis of dengue infection.
    Matched MeSH terms: Thrombocytopenia
  2. Fulltext A case report of severe Ascariasis infection in systemic lupus erythematosus patient
    Tan J. Y. S., R. Surendran, Mohd Noh Malehah, Shaila Kabir, Chong Y. Y. Eleen
    Malaysian Journal of Medicine and Health Sciences, 2019;15(106):53-53.
    MyJurnal
    Introduction: Ascariasis is a parasitic infection, which commonly affects immunocompromised patients. Most pa-tients remained asymptomatic during the early larval migration stage and respond well with conventional anti-hel-minthic drugs. Previous literature had reported symptomatic Ascaris infection mimicking bacterial pneumonia and the typical eosinophilia found in Loeffler syndrome was absent in patients on corticosteroids. Thus, a high index of suspicion for ascariasis is needed for immunosuppressed patients presented with infection. We present here a case of severe ascariasis infection in a systemic lupus erythematosus patient. Case description: A 16-year-old boy presented with fever, generalized maculopapular rash associated with neutropenia and thrombocytopenia. He was treated initially as Dengue Fever initially. However his symptoms did not resolve at even day 14 of admission. On further assessment, we were convinced he has SLE based upon presence of malar rash, oral ulcers, urinary protein-uria, persistent leucopenia, thrombocytopenia with low complements and ANA positive. He was promptly started on IV hydrocortisone. He showed a good progress in the first few days. On day 5 of admission, he coughed out a round worm which later identified as Ascarisis lumbricoides. He was started on Albendazole. Unfortunately he developed hemoptysis and respiratory compromisation where he required intubation. Post intubation he went into cardiac arrest, which required CPR. Following that event, his condition further deteriorated with multi organ failure. He succumbed to his illness three days later. Conclusion: Immunocompromised patients are prone to opportunistic infections including parasitic infections. we present here a case of ascariasis in an SLE patient who unfortunately succumbed to the illness. Due to the variable clinical symptoms that mimic other infections, screening for parasitic infections needs to be considered especially if the patients do not respond to antibiotics and routine treatments.
    Matched MeSH terms: Thrombocytopenia
  3. A four-point clinical criteria distinguishes immune thrombocytopenia from acute lymphoblastic leukaemia
    Lum SH, How SJ, Ariffin H, Krishnan S
    Med J Malaysia, 2016 02;71(1):28-9.
    PMID: 27130741
    Immune thrombocytopenia is the most common diagnosis of isolated thrombocytopenia. The dilemma encountered by paediatricians is missing diagnosis of acute leukaemia in children with isolated thrombocytopenia. We demonstrated childhood ITP could be diagnosed using a four point clinical criteria without missing a diagnosis of acute leukaemia. Hence, bone marrow examination is not necessary in children with typical features compatible with ITP prior to steroid therapy. This can encourage paediatricians to choose steroid therapy, which is cheaper and non-blood product, as first line platelet elevating therapy in children with significant haemorrhage.
    Matched MeSH terms: Thrombocytopenia
  4. Adult dengue haemorrhagic fever at Kuala Lumpur Hospital: retrospective study of 102 cases
    Ibrahim NM, Cheong I
    Br J Clin Pract, 1995 Jul-Aug;49(4):189-91.
    PMID: 7547159
    A retrospective study involving 102 adults with dengue haemorrhagic fever (DHF) was conducted to investigate the demographic aspect, clinical presenting features, laboratory investigations, complications, and mortality associated with the disease. The clinical diagnosis of DHF was in accordance with WHO recommendations. Epistaxis, gingivitis, haematemesis and gastritis were among the common complications. Platelet levels tended to decline from a higher value on admission (mean 67,000/mm3) to lower levels on subsequent days, with the lowest (mean 61,000/mm3) being on day 6 of the fever. Hyponatraemia (46.8%) was commonly observed. Morbidity of DHF was significant (29.4%) but the case fatality rate remained low (2.0%) in our adults, suggesting that adults are less likely than children to suffer from shock syndrome.
    Matched MeSH terms: Thrombocytopenia/epidemiology; Thrombocytopenia/therapy
  5. Fulltext An uncommon cause of leg swelling after exercise: a case report on an unprovoked deep vein thrombosis in young healthy man
    Rathika Rajah, Alvin Oliver Payus, Norlaila Mustafa
    Malaysian Journal of Medicine and Health Sciences, 2020;16(1):351-353.
    MyJurnal
    Antiphospholipid syndrome is a hypercoagulable autoimmune condition that predominantly affect the female and commonly manifest as arterio-venous thrombosis and recurrent miscarriage. Here, we present a unique case of a healthy young man who developed sudden onset of right leg swelling after exercise which was then found to be due to deep vein thrombosis via Doppler ultrasound. His blood investigations showed thrombocytopenia and prolonged coagulation profile. Therefore, antiphospholipid syndrome was suspected and later confirmed by positive autoim- mune antibodies. He was treated with long term moderate intensity oral warfarin. The objective of this case report is to share the uncommon occurrence of an unprovoked deep vein thrombosis secondary to antiphospholipid syn- drome in a healthy young man so that the possibility of deep vein thrombosis should be suspected in selected cases of non-resolving leg swelling after exercise as it can lead to fatal pulmonary embolism.
    Matched MeSH terms: Thrombocytopenia
  6. An unusual presentation of gestational thrombocytopenia
    Lim CC, Patel DK, Bakhtiari A, Subrayan V
    Platelets, 2013;24(6):498-9.
    PMID: 22994680 DOI: 10.3109/09537104.2012.724484
    Thrombocytopenia is classically defined as a platelet count of less than 150 000/µl. Counts from 100 000 to 150 000/µl are considered mildly depressed, 50 000 to 100 000/µl moderately depressed, and less than 50 000/µl severely depressed. Thrombocytopenia occurs in about 10% of pregnant women. Gestational thrombocytopenia (GT) is a diagnosis of exclusion and considered the most prevalent cause of thrombocytopenia in pregnancy. GT accounts for almost 75% of cases of thrombocytopenia in pregnancy. The cause of GT is unclear, although existing studies denote the possibility of accelerated platelet consumption and the increased plasma volume during pregnancy. The presence of antiplatelet antibodies is not specific to GT. The degree of thrombocytopenia in GT is usually mild to moderate, usually remaining greater than 70 000/µl. Patients are asymptomatic with no evidence of bleeding and rarely preconception history of thrombocytopenia. The platelet count returns to normal within 2-12 weeks post partum. We wish to report a unique case of GT presenting as blurred vision due to retinal hemorrhages.
    Matched MeSH terms: Thrombocytopenia/diagnosis*
  7. Fulltext Anticardiolipin antibodies in patients from Malaysia with systemic lupus erythematosus
    Jones HW, Ireland R, Senaldi G, Wang F, Khamashta M, Bellingham AJ, et al.
    Ann Rheum Dis, 1991 Mar;50(3):173-5.
    PMID: 2015010 DOI: 10.1136/ard.50.3.173
    Systemic lupus erythematosus (SLE) is highly prevalent in Malaysia, which has a mixed population of Malays, Chinese, and Indians. A quantitative enzyme linked immunosorbent assay (ELISA) was used to determine anticardiolipin antibody (aCL) levels (total immunoglobulin, IgG, and IgM) in 200 patients with SLE (164 Chinese, 26 Malay, and 10 Indian) attending the University Hospital of Kuala Lumpur, Malaysia, and 103 matched controls. Only 33 (16.5%) of the patients had raised aCL levels; 26 had raised IgG aCL, five IgM aCL, and two both IgG and IgM aCL. There was a low prevalence of raised levels of aCL in the population studied, which was seen in conjunction with a rare occurrence of thrombosis. The classical association of high aCL levels with thrombocytopenia and recurrent abortions was noted, though not with cerebral disease. The low prevalence of aCL in this study population of mixed racial origin contrasts with findings in European patients with SLE and lends support to the influence of local factors, be they genetic or environmental, on the clinical manifestations of this disease.
    Matched MeSH terms: Thrombocytopenia/immunology
  8. Fulltext Anticardiolipin antibody isotype profile in lupus nephritis--a cross sectional survey
    Azizah MR, Loo CS, Zulkifli MN, Shahnaz M, Zaki M, Nasuruddin BA
    Med J Malaysia, 1998 Sep;53(3):257-62.
    PMID: 10968163
    Thirty-six patients with lupus nephritis (LN) attending the Nephrology Clinic, Hospital Kuala Lumpur were studied for the prevalence of anticardiolipin antibody (ACA) isotypes (IgG and IgM) and other associated antibodies, antinuclear antibody (ANA) and anti-ds DNA antibody and to determine the possible association between serological and clinical parameters. The study population consisted of 20 (55.6%) Malays, 15 (41.7%) Chinese and 1 (2.8%) Indian with a mean age of 31.4 +/- 11.3 years, range 14 to 60 years. The female to male ratio was 11:1. The average time between diagnosis and blood sampling was 4.4 years (range 0.25 to 15 years). Increased ACA levels were found in 20 (55.6%) patients where raised IgG ACA and IgM ACA were observed in 20 (55.6%) and 2 (5.6%) cases respectively. ANA and anti-ds DNA antibodies were detected in 22 (61.1%) and 4 (11.1%) individuals respectively, with the majority (82%) showing a speckled pattern of nuclear staining. However, neither the IgM ACA nor IgG ACA showed any significant association with thrombosis or any other clinical parametres. Our preliminary study indicates that ACA is a frequent finding in lupus nephritis and that the IgG isotype is more prevalent.

    Study site: nephrology Clinic, Hospital Kuala Lumpu
    Matched MeSH terms: Thrombocytopenia/immunology
  9. Anticoagulation Therapy in Patients with Chronic Kidney Disease
    Saheb Sharif-Askari F, Syed Sulaiman SA, Saheb Sharif-Askari N
    Adv Exp Med Biol, 2017;906:101-114.
    PMID: 27628006
    Patients with chronic kidney disease (CKD) are at increased risk for both thrombotic events and bleeding. The early stages of CKD are mainly associated with prothrombotic tendency, whereas in its more advanced stages, beside the prothrombotic state, platelets can become dysfunctional due to uremic-related toxin exposure leading to an increased bleeding tendency. Patients with CKD usually require anticoagulation therapy for treatment or prevention of thromboembolic diseases. However, this benefit could easily be offset by the risk of anticoagulant-induced bleeding. Treatment of patients with CKD should be based on evidence from randomized clinical trials, but usually CKD patients are excluded from these trials. In the past, unfractionated heparins were the anticoagulant of choice for patients with CKD because of its independence of kidney elimination. However, currently low-molecular-weight heparins have largely replaced the use of unfractionated heparins owing to fewer incidences of heparin-induced thrombocytopenia and bleeding. We undertook this review in order to explain the practical considerations for the management of anticoagulation in these high risk population.
    Matched MeSH terms: Thrombocytopenia/complications; Thrombocytopenia/pathology; Thrombocytopenia/prevention & control
  10. Antithrombocytopenic activity of carpaine and alkaloidal extract of Carica papaya Linn. leaves in busulfan induced thrombocytopenic Wistar rats
    Zunjar V, Dash RP, Jivrajani M, Trivedi B, Nivsarkar M
    J Ethnopharmacol, 2016 Apr 02;181:20-5.
    PMID: 26812680 DOI: 10.1016/j.jep.2016.01.035
    ETHNOPHARMACOLOGICAL RELAVANCE: The decoction of Carica papaya Linn. leaves is used in folklore medicine in certain parts of Malaysia and Indonesia for the treatment of different types of thrombocytopenia associated with diseases and drugs. There are several scientific studies carried out on humans and animal models to confirm the efficacy of decoction of papaya leave for the treatment of disease induced and drug induced thrombocytopenia, however very little is known about the bio-active compounds responsible for the observed activity. The aim of present study was to identify the active phytochemical component of Carica papaya Linn. leaves decoction responsible for anti-thrombocytopenic activity in busulfan-induced thrombocytopenic rats.

    MATERIALS AND METHODS: Antithrombocytopenic activity was assessed on busulfan induced thrombocytopenic Wistar rats. The antithrombocytopenic activity of different bio-guided fractions was evaluated by monitoring blood platelet count. Bioactive compound carpaine was isolated and purified by chromatographic methods and confirmed by spectroscopic methods (LC-MS and 1D/2D-1H/13C NMR) and the structure was confirmed by single crystal X-ray diffraction. Quantification of carpaine was carried out by LC-MS/MS equipped with XTerra(®) MS C18 column and ESI-MS detector using 90:10 CH3CN:CH3COONH4 (6mM) under isocratic conditions and detected with multiple reaction monitoring (MRM) in positive ion mode.

    RESULTS: Two different phytochemical groups were isolated from decoction of Carica papaya leaves: phenolics, and alkaloids. Out of these, only alkaloid fraction showed good biological activity. Carpaine was isolated from the alkaloid fraction and exhibited potent activity in sustaining platelet counts upto 555.50±85.17×10(9)/L with no acute toxicity.

    CONCLUSIONS: This study scientifically validates the popular usage of decoction of Carica papaya leaves and it also proves that alkaloids particularly carpaine present in the leaves to be responsible for the antithrombocytopenic activity.

    Matched MeSH terms: Thrombocytopenia/chemically induced; Thrombocytopenia/drug therapy*
  11. Aspects of obstetrical defibrination in West Malaysia
    White JC, Chan LK, Lau KS, Sen DK
    J Trop Med Hyg, 1976 Jun;79(6):132-6.
    PMID: 1084931
    Five patients illustrate various aspects of obstetrical defibrination in West Malaysia, resulting from exaggeration of changes in fibrinolytic-coagulation equilibrium that occur at delivery. Hypofibrinogenaemia and fibrinolysis may occur in association or either feature predominate. These patients are from a population in which a variety of genetic and environmental factors may interact, e.g. abnormal haemoglobins, cold agglutinins, viral and other infections, introducing additional complications.
    Matched MeSH terms: Thrombocytopenia/blood
  12. Fulltext Assessing biomarkers on exposure, effects and susceptibility for environmental and occupational exposure of various range of benzene
    Noor Fatihah MF, Suhaili A, Juliana J
    Malaysian Journal of Public Health Medicine, 2017;17 Special(1):7-18.
    Background: Benzene is primarily routed by inhalation which highly sensitive to blood parameters as bone marrow is their target organ. The ability of benzene even in low exposure levels may induce human bone marrow suppression resulting in blood diseases such as leukopenia, anemia, thrombocytopenia, aplastic anemia, and pancytopenia. In the occupational setting, the most common benzene-exposed workers are from the petrochemical industries and petrol distribution such as gasoline pumps. Benzene also generated primarily by mobile exhaust and some from various of anthropogenic sources at environmental atmosphere and occupationally exposed in the policemen traffic, taxi and bus drivers, and street vendors in long-length time with low concentration exposure. Methodology: This paper reviewed published articles on biomarkers exposure, effects and susceptibility as the useful tools for benzene exposure assessment in the occupational and environmental setting. Data from previous epidemiological studies relevant to benzene exposure in various occupational and environmental setting is also summarized. Results: Based on these analyses, the findings agreed that these biomarkers are could suggest in linking the benzene exposure with possible adverse health effects. The biological monitoring used in epidemiological studies is useful in providing an understanding of activation and detoxification of benzene in both the occupational and general population as they are exposed to wide range of benzene concentration. Conclusion. The biomarkers of exposure, effects, and susceptibility utilized for benzene exposure assessment are valid tools in determining the greatest potential risk as well as an early biological effect which then caused a related specific disease.
    Matched MeSH terms: Thrombocytopenia
  13. Fulltext Autoimmune polyglandular syndrome presenting with jaundice and thrombocytopenia
    Norasyikin AW, Rozita M, Mohd Johan MJ, Suehazlyn Z
    Med Princ Pract, 2014;23(4):387-9.
    PMID: 24401542 DOI: 10.1159/000357645
    OBJECTIVE: To report an uncommon presentation of a rare case of autoimmune polyglandular syndrome type IIIb in an elderly woman.
    CLINICAL PRESENTATION AND INTERVENTION: A 62-year-old woman presented with anaemic symptoms and jaundice. Blood tests showed macrocytic anaemia due to vitamin B12 deficiency with Coombs negative haemolysis. A thyroid function test was consistent with hypothyroidism. Autoimmune antibody assays were positive for anti-parietal cell, anti-intrinsic factor and anti-thyroid peroxidase antibodies. A final diagnosis of autoimmune thyroiditis with pernicious anaemia, which constituted autoimmune polyglandular syndrome type IIIb, was made and the patient was treated with L-thyroxine, vitamin B12 injection and a blood transfusion. She was discharged uneventfully after a week of hospitalization.
    CONCLUSION: This case showed that the presence of one autoimmune endocrine disease should prompt clinicians to look for other coexisting autoimmune diseases which may be asymptomatic despite positive autoantibodies.
    Matched MeSH terms: Thrombocytopenia/physiopathology
  14. Autoimmune thrombocytopenia and neutropenia after autologous peripheral blood stem cell transplantation
    Wahid FS, Cheong SK, Sivagengei K
    Acta Haematol., 2002;107(4):237-8.
    PMID: 12053154
    Matched MeSH terms: Thrombocytopenia/drug therapy; Thrombocytopenia/etiology*; Thrombocytopenia/immunology
  15. Fulltext Autosomal dominant thrombocytopenia with microthrombocytes: a family study
    Jackson N, Mohammad S, Zainal N, Jamaluddin N, Hishamuddin M
    Med J Malaysia, 1995 Dec;50(4):421-4.
    PMID: 8668069
    A family demonstrating autosomal dominant thrombocytopenia is described. A 28-year-old Malay housewife was found to have a platelet count of 40 x 10(9)/l with a low mean platelet volume (6.8 fl) while being investigated prior to ovarian cystectomy. The bone marrow was consistent with immune thrombocytopenia but she failed to respond to appropriate therapy. Five siblings, one parent and one nephew have easy bruising and platelet counts of 39-82 x 10(9)/l. Platelet aggregation studies excluded a major functional defect. Survival of homologous platelets in the circulation was normal. Familial thrombocytopenias are rare but important to differentiate from the common acquired thrombocytopenias in order to spare the patient unnecessary treatments.
    Matched MeSH terms: Thrombocytopenia/genetics*
  16. Fulltext Bilateral Emphysematous Pyelonephritis with Hepatic Portal Venous Gas: Case Report
    Cheng ML, Nording H, Lim CH
    Malays J Med Sci, 2015 May-Jun;22(3):71-4.
    PMID: 26715900 MyJurnal
    Emphysematous pyelonephritis is a rare life-threatening condition caused by a severe acute necrotising infection of the renal parenchyma and its perinephric tissues, and it is commonly seen in diabetic patients. There is a rare association between emphysematous pyelonephritis and hepatic portal venous gas. Hepatic portal venous gas is an uncommon radiological finding, which implies a significant underlying abdominal disease. The management of emphysematous pyelonephritis has evolved from prompt nephrectomy to medical therapy. In the present report, we present a case of a diabetic woman diagnosed with bilateral emphysematous pyelonephritis with hepatic portal venous gas that was successfully managed medically despite the presence of poor prognostic factors, such as acute renal failure and thrombocytopenia.
    Matched MeSH terms: Thrombocytopenia
  17. Bleeding after Malayan pit viper bites
    Chan KE
    Southeast Asian J. Trop. Med. Public Health, 1979 Jun;10(2):276-9.
    PMID: 524154
    Matched MeSH terms: Thrombocytopenia/blood
  18. Bleeding manifestations in snake bite
    Devaraj T
    Southeast Asian J. Trop. Med. Public Health, 1979 Jun;10(2):255-7.
    PMID: 524151
    Bleeding following bites by the Malayan Pit Viper can either be local or systemic. Bleeding at the site of the bite is due to the local action of the venom as a vasculotoxin. Systemic bleeding occurs with severe poisoning and appears to be mainly dependent on platelet deficiency and the co-existing defibrination syndrome appears to play a minor role in the initiation of bleeding. Thus in the clinical situation non-clotting blood with no overt bleeding can continue up to weeks when specific antivenene is not given. Assessment of the severity of poisoning can easily be made at the bedside. Specific viper antivenene rapidly corrects the spontaneous bleeding and clotting defect of severe systemic poisoning but has no effect on local poisoning.
    Matched MeSH terms: Thrombocytopenia/blood
  19. Fulltext Bone marrow and peripheral blood changes in non-Hodgkin's lymphoma
    Lim EJ, Peh SC
    Singapore Med J, 2000 Jun;41(6):279-85.
    PMID: 11109344
    47 patients with non-Hodgkin's lymphoma (NHL) were studied retrospectively to determine their marrow and blood changes at diagnosis.
    Matched MeSH terms: Thrombocytopenia/etiology
  20. Fulltext Case series of naturally acquired Plasmodium knowlesi infection in a tertiary teaching hospital
    Azira NM, Zairi NZ, Amry AR, Zeehaida M
    Trop Biomed, 2012 Sep;29(3):398-404.
    PMID: 23018503 MyJurnal
    Plasmodium knowlesi is a simian malaria parasite and is recently recognized as the fifth malaria parasite infecting humans. Manifestation of the infection may resemble other infection particularly dengue fever leading to inappropriate management and delay in treatment. We reported three cases of naturally acquired P. knowlesi in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. Clinical manifestations were quite similar in those cases. Microscopically, the diagnosis might be challenging. These cases were confirmed by polymerase chain reaction method which serves as a gold standard.
    Matched MeSH terms: Thrombocytopenia/diagnosis*; Thrombocytopenia/drug therapy; Thrombocytopenia/parasitology
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