MyMedR

Periodic lateralized epileptiform discharges in neuropsychiatric lupus: association with cerebritis in magnetic resonance imaging and resolution after intravenous immunoglobulin

Lim KS, Cheong KL, Tan CT

Lupus, 2010 May;19(6):748-52.

PMID: 20133346 DOI: 10.1177/0961203309351539

A 13-year-old girl with a known diagnosis of systemic lupus erythematosus presented with seizures and psychosis. An electroencephalogram (EEG) revealed continuous, non-evolving periodic lateralized epileptiform discharges (PLEDs) in the left temporal region, which did not resolve with benzodiazepine. A magnetic resonance imaging (MRI) brain scan demonstrated a focal hyperintensity in the left medial temporal and left occipital lobes, left thalamus and bilateral cerebellar white matter, with evidence of vasculitis in the magnetic resonance angiography. Intravenous immunoglobulin was given because of failed steroid therapy, which resulted in a full resolution of clinical, EEG and MRI abnormalities. Lupus cerebritis should be considered as a possible aetiology in PLEDs, and immunoglobulin can be effective in neuropsychiatric lupus.

Matched MeSH terms: Adolescent

Fulltext Outcome of patients presenting with idiopathic facial nerve paralysis (Bell's palsy) in a tertiary centre--a five year experience

Tang IP, Lee SC, Shashinder S, Raman R

Med J Malaysia, 2009 Jun;64(2):155-8.

PMID: 20058577

This is a retrospective study. The objective of this study is to review the factors influencing the outcome of treatment for the patients presented with idiopathic facial nerve paralysis. The demographic data, clinical presentation and management of 84 patients with idiopathic facial nerve paralysis (Bell's palsy) were collected from the medical record office, reviewed and analyzed from 2000 to 2005. Thirty-four (72.3%) out of 47 patients who were treated with oral prednisolone alone, fully recovered from Bell's palsy meanwhile 36 (97%) out of 37 patients who were treated with combination of oral prednisolone and acyclovir fully recovered. The difference was statistically significant. 42 (93.3%) out of 45 patients who presented within three days to our clinic, fully recovered while 28 (71.8%) out of 39 patients presented later then three days had full recovery from Bell's palsy. The difference was statistically significant. The outcome of full recovery is better with the patients treated with combined acyclovir and prednisolone compared with prednisolone alone. The patients who were treated after three days of clinical presentation, who were more than 50 years of age, who had concurrent chronic medical illness and facial nerve paralysis HB Grade IV to VI during initial presentation have reduced chance of full recovery of facial nerve paralysis.

Matched MeSH terms: Adolescent

Fulltext Post viral acute multifocal posterior placoid pigment epithiopathy in a teenage child

Nga AD, Ramli N, Mimiwati Z

Med J Malaysia, 2009 Jun;64(2):176-8.

PMID: 20058585 MyJurnal

We report a rare case of a young boy presenting with bilateral blurring of vision following a viral like illness. Fundus examination revealed multiple pale cream-coloured lesions scattered across the posterior pole of both eyes. Fundus fluorescein angiography showed characteristic features of early hypofluorescence and late hyperfluorescence, further confirming the diagnosis of acute posterior placoid pigment epitheliopathy (AMPPPE). He was treated with topical steroids for the accompanying mild anterior uveitis. He had a prompt visual recovery with no adverse sequelae.

Matched MeSH terms: Adolescent

Fulltext Handlebar herniation: a case of near missed abdominal injury

Chew KS, Amin NM

Med J Malaysia, 2009 Jun;64(2):170-1.

PMID: 20058582 MyJurnal

Timely identification of specific injuries in a polytrauma case is of paramount importance in order to reduce morbidity and mortality. Unfortunately, some of these injuries are subtle and can be missed on initial primary and secondary assessments. In this paper, we report one such injury in a case of a 16-year old motorcyclist who complained of abdominal pain over the right lumbar region after the motorcycle handlebar hit his abdomen. Although initial assessment was uneventful, he was subsequently diagnosed to have a traumatic abdominal wall herniation on abdominal computed tomography after more than 24 hours of observation in the ward.

Matched MeSH terms: Adolescent

Fulltext Barriers to the utilization of primary care services for mental health prolems among adolescents in a secondary school in Malaysia

Aida J, Noor Azimah M, Mohd Radzniwan AR, Tuti Iryani MD, Ramli M, Khairani O

Malays Fam Physician, 2010;5(1):31-5.

PMID: 25606183

OBJECTIVE: To study the barriers toward the utilization of primary care services for mental health problems among adolescents in a secondary school in Hulu Langat, Selangor, Malaysia.
METHODS: This was a cross-sectional study conducted in July 2008 at a secondary school in Hulu Langat, Selangor. The respondents were selected using randomised cluster sampling among Form Four and Form Five students. Students were given self-administered questionnaire, consisting socio-demographic data and questions on their help-seeking barrier and behaviour. Help-seeking behaviour questions assess the use of medical facility and help-seeking sources. The formal help-seeking sources include from teachers, counsellors and doctors. The informal help-seeking sources include from friends, parents and siblings.
RESULTS: A total of 175 students were included in the study. None of the students admitted of using the primary health care services for their mental health problems. Majority of the students were not aware of the services availability in the primary health care (97.1%). More than half of them thought the problems were due to their own mistakes (55.4%) and the problems were not that serious (49.1%). With regard to perception of the primary health care services, (43.2%) of the students were worried about confidentiality, half of them were concerned about other people's perception especially from their family members (44.6%) and friends (48.6%). Minority of them (10.8%) thought that nobody can help them. Few of them thought smoking (3.4%), alcohol (3.4%) and recreational drugs (1.1%) can solve their emotional problems.
CONCLUSION: One of the major barriers identified in the students' failure to use the health care facilities was their unawareness of the availability of the service for them in the community. Thus there is a need to promote and increase their awareness on this issue.

Matched MeSH terms: Adolescent

A study into salivary-based measurement of human stress subjected to Ellestad stress test protocol

Lee YK, Za'aba A, Madzhi NK, Ahmad A

Annu Int Conf IEEE Eng Med Biol Soc, 2009;2009:765-8.

PMID: 19964239 DOI: 10.1109/IEMBS.2009.5333674

Previous works on the effects of salivary alpha amylase in respond to various stressors report encouraging findings on it being a good indicator of stress. Ellestad protocol is a clinical procedure to screen for coronary artery disease by introducing exercise induced physical stress. If a salivary based biomarker profile in accordance to a stress test protocol could be established, the critical stress state which disable rational decision making could be ascertained in a standardized procedure. This technique would serve to aid human resource management in times of critical events such as rescue, firefighting or even military, that would potentially prevent unnecessary sacrifice of human lives. In this pilot study with five healthy volunteers performing the Ellestad protocol treadmill, a measurement profile with physiologic and salivary based biomarker is obtained. It is found that the alpha amylase levels or the changes in it as workload changes from resting-walking-running at ease-exhaustive running, is relatively more significant in reflecting the stress state than heart rate and blood pressure. Moreover, it is strongly associated with mood state with correlation coefficient of 0.8 and significance of 0.01.

Matched MeSH terms: Adolescent

Birthweight and early neonatal health: Bangladesh perspective

Ullah A, Barman A, Haque J, Khanum M, Bari I

Paediatr Perinat Epidemiol, 2009 Nov;23(6):542-7.

PMID: 19840290 DOI: 10.1111/j.1365-3016.2009.01063.x

It has been suggested that a birthweight limit of 2.5 kg should not be regarded as valid for all populations as the cut-off point of low-weight births because of demographic, genetic and environmental differences. Countries often choose alternative cut-off values for low birthweight for clinical purposes. Bangladesh also needs to choose a convenient cut-off value for low birthweight. A total of 770 live singleton full-term normal newborns were included in this study by stratified sampling; birthweight was measured using the Detecto-type baby weight machine. Newborns were followed up to the end of their first week of life. For data collection a pretested structured questionnaire and an Apgar Score estimating checklist were used. Chi-square test was applied to assess the association of different birthweight strata and neonatal health outcomes. Multiple logistic regression analyses were carried out to identify the independent effects of different levels of birthweight on early neonatal health. The neonates having birthweight < or = 2 kg had a significantly higher risk of early neonatal mortality and morbidity than the higher level birthweight group. Birth asphyxia was the commonest cause of early neonatal mortality and morbidity. Borderline birthweight (>2 to <2.5 kg) neonates experienced the same mortality and morbidity rates as the normal birthweight neonates during their early neonatal life. Birthweight < or = 2 kg may be one of the criteria for admission to a neonatal intensive care unit whereas more than 2 kg may not require admission unless otherwise necessary.

Matched MeSH terms: Adolescent

Fulltext Prevalence of clinical malaria among an Orang Asli community in Malaysia

Kaur G

Southeast Asian J. Trop. Med. Public Health, 2009 Jul;40(4):665-73.

PMID: 19842399

An epidemiological cross-sectional study was undertaken to determine the prevalence of clinical malaria among the Orang Asli population of Raub, Pahang, Malaysia. The study was conducted on a representative sample of 520 Orang Asli. Malariometric and clinical measurements were taken. The overall parasitemic rate was 24.2% (95% CI 20.7-28.1). Twenty-three point four percent (95% CI 19.5-26.9) of respondents age two years and above were clinically febrile. The prevalence of fever, chills, perspiration and body aches during a one month period prior to the survey among the same group ranged between 4.2% (95% CI 2.7-6.4) and 13.5% (95% CI 10.6-16.7). Children 2-12 years old were more likely to present with fever, and symptoms of malaria than older children. Gender was not significantly associated with fever or any of the other malaria symptoms. Presence of clinical fever and history of malaria symptoms were all strongly associated with current infection. The association was significant even after controlling for age (adjusted OR 2.8-5.1, 95% CI 1.1-8.3). Orang Asli children significantly experienced greater morbidity due to malaria compared to adults. Control and treatment of malaria should focus on children, while further research should explore the effects of malaria morbidity on the quality of life of these children.

Matched MeSH terms: Adolescent

Diagnostic challenge of gastrointestinal tuberculosis: a report of 34 cases and an overview of the literature

Radzi M, Rihan N, Vijayalakshmi N, Pani SP

Southeast Asian J. Trop. Med. Public Health, 2009 May;40(3):505-10.

PMID: 19842436

We report 34 cases of gastrointestinal TB from Malaysia and present an overview of the diagnostic challenges. A concerted effort is necessary to improve the existing diagnostic methods, and develop and evaluate newer diagnostic tools through well designed multi-center studies.

Matched MeSH terms: Adolescent

Arterial thrombosis and critical limb ischaemia in a case of nephrotic syndrome

Koh KH, Tan C, Tan S, Ngu L

Nephrology (Carlton), 2009 Sep;14(6):622.

PMID: 19712262 DOI: 10.1111/j.1440-1797.2008.01001.x

Matched MeSH terms: Adolescent

Fulltext Medical thoracoscopy: Pahang experience

Ng TH, How SH, Kuan YC, Hasmah H, Norra H, Fauzi AR

Med J Malaysia, 2008 Oct;63(4):298-301.

PMID: 19385488 MyJurnal

Medical thoracoscopy has gain its popularity in Malaysia recently. This paper presents our early experience in thoracoscopy using semi-rigid fiberoptic thoracoscope. All thoracoscopy records since October 2006 were retrieved. The patients' records, thoracocentesis investigations results, thoracoscopic findings and all pleural biopsy results were reviewed. Twenty-four thoracoscopic procedures on 22 patients in whom two patients had repeated thoracoscopy. Ten patients were confirmed carcinoma. Eight patients had inconclusive thoracoscopic pleural biopsy results. Three patients underwent pleurodesis for malignant effusion. One patient had adhesiolysis for empyema. There was no procedure-related deaths or intraoperative accidents. Thoracoscopy is a relatively safe procedure.

Matched MeSH terms: Adolescent

Fulltext Endoscopic resection of primary nasoseptal chondrosarcoma

Jenny L, Harvinder S, Gurdeep S

Med J Malaysia, 2008 Oct;63(4):335-6.

PMID: 19385498 MyJurnal

Chondrosarcoma of the nasal septum is an extremely rare malignant tumor. It accounts for only 10% to 20% of primary bone tumors, with approximately 10% found in the head and neck. A case is presented here to illustrate its presentation, evaluation and surgical treatment.

Matched MeSH terms: Adolescent

Sleep habits and disturbances in Malaysian children with epilepsy

Ong LC, Yang WW, Wong SW, alSiddiq F, Khu YS

J Paediatr Child Health, 2010 Mar;46(3):80-4.

PMID: 20105259 DOI: 10.1111/j.1440-1754.2009.01642.x

To compare sleep habits and disturbances between Malaysian children with epilepsy and their siblings (age range 4-18 years) and to determine the factors associated with greater sleep disturbance.

Matched MeSH terms: Adolescent

Morphological comparison between adolescent and adult lumbar pedicles using computerised tomography scanning

Mughir AM, Yusof MI, Abdullah S, Ahmad S

Surg Radiol Anat, 2010 Jul;32(6):587-92.

PMID: 20047027 DOI: 10.1007/s00276-009-0612-x

To study the morphological difference between the lumbar pedicle in adolescent and adult groups as only less information is known about their pedicle morphology, especially in Malaysian population.

Matched MeSH terms: Adolescent

Variations in tooth size and arch dimensions in Malay schoolchildren

Hussein KW, Rajion ZA, Hassan R, Noor SN

Aust Orthod J, 2009 Nov;25(2):163-8.

PMID: 20043553

To compare the mesio-distal tooth sizes and dental arch dimensions in Malay boys and girls with Class I, Class II and Class III malocclusions.

Matched MeSH terms: Adolescent

Fulltext Is emmetropia the natural endpoint for human refractive development? An analysis of population-based data from the refractive error study in children (RESC)

Morgan IG, Rose KA, Ellwein LB, Refractive Error Study in Children Survey Group

Acta Ophthalmol, 2010 Dec;88(8):877-84.

PMID: 19958289 DOI: 10.1111/j.1755-3768.2009.01800.x

PURPOSE: To determine the natural end-point for refractive development during childhood.

METHODS: Cycloplegic (1% cyclopentolate) autorefraction was performed on 38, 811 children aged 5 and 15 in population-based samples at eight sites in the Refractive Error Study in Children (RESC). Refractions (right eye) were categorized as myopic (≤-0.5 D), emmetropic (>-0.5 to ≤+0.5 D), mildly hyperopic (>+0.5 to ≤+2.0 D and hyperopic (>+2.0 D).

RESULTS: At five sites (Jhapa - rural Nepal, New Delhi - urban India, Mahabubnagar - rural India, Durban - semi-urban South Africa and La Florida - urban Chile), there was <20% myopia by age 15. Mild hyperopia was the most prevalent category at all ages, except for Mahabubnagar where emmetropia became the marginally most prevalent category at ages 14 and 15. At the other sites (Gombak - semi-urban Malaysia, Shunyi - semi-rural China and Guangzhou - urban China), there was substantial (>35%) myopia by age 15. At these sites, mild hyperopia was the most prevalent category during early childhood, and myopia became the predominant category later. In Gombak district and Guangzhou, emmetropia was a minor category at all ages, with myopia increasing as mild hyperopia decreased. In Shunyi district, emmetropia was the most prevalent category over the ages 11-14.

CONCLUSION: Emmetropia was not the predominant outcome for refractive development in children. Instead, populations were predominantly mildly hyperopic or substantial amounts of myopia appeared in them. This suggests that mild hyperopia is the natural state of refractive development in children and that emmetropia during childhood carries the risk of subsequent progression to myopia.

Matched MeSH terms: Adolescent

Displaced medial epicondyle fractures of the humerus: surgical treatment and results. A report of 139 cases

Louahem DM, Bourelle S, Buscayret F, Mazeau P, Kelly P, Dimeglio A, et al.

Arch Orthop Trauma Surg, 2010 May;130(5):649-55.

PMID: 19960347 DOI: 10.1007/s00402-009-1009-3

Elbow instability is a common feature after medial epicondyle fractures, displaced or not, even in the absence of dislocation. Undisplaced or minimally displaced fractures often have an underestimated degree of instability secondary to unrecognised capsuloligamentous and muscular injuries. The purpose of this retrospective study was to analyze and to assess objectively the results of the surgical treatment of these acute injuries.

Matched MeSH terms: Adolescent

Fulltext The risk factors for unexplained antepartum stillbirths in Scotland, 1994 to 2003

Sutan R, Campbell D, Prescott GJ, Smith WC

J Perinatol, 2010 May;30(5):311-8.

PMID: 19829298 DOI: 10.1038/jp.2009.158

To determine the factors contributing to unexplained antepartum stillbirth in Scotland.

Matched MeSH terms: Adolescent

Role of men in promoting the uptake of HPV vaccinations: focus groups' finding from a developing country

Wong LP

Int J Public Health, 2010 Feb;55(1):35-42.

PMID: 19771393 DOI: 10.1007/s00038-009-0072-4

OBJECTIVES: Better outcomes of human papillomavirus (HPV) vaccination would be expected if men become full partners and advocates in vaccination initiative. Men involvement has important implication especially within the context that they are equally responsible for spreading the virus.

METHODS: Twenty-seven men took part in four focus group discussions carried out to assess men's attitudes toward the HPV vaccine between October and November 2007.

RESULTS: The results revealed that men have low awareness about the newly release vaccine and minimal knowledge of HPV and its association with cervical cancer. When provided with information, most men were in favor of protecting their spouses, partners, or daughters from cervical cancer using the vaccine. They were aware of the effects of men's risk behavioral patterns on women's risk for acquiring HPV infections. Many needed assurance about the vaccine's long-term safety and efficacy. They also expressed concern over the high cost of the vaccine. Men in this study played an influential role in the vaccination decision of their child and sexual partners. Many were in favor of male vaccination for cervical cancer prevention of their spouse or partner.

CONCLUSIONS: Vaccine advocacy should put special emphasis on men as sexual partners, husbands, and fathers from a gender equality and partnership perspective. The findings are useful in facilitating the development of strategies for effective immunization initiatives.

Matched MeSH terms: Adolescent

Prevalence of work-related upper limbs symptoms (WRULS) among office workers

Zairina Abdul Rahman, Abdul Sallam Atiya

Asia Pac J Public Health, 2009 Jul;21(3):252-8.

PMID: 19546127 DOI: 10.1177/1010539509341423

An analytical cross-sectional study was carried out to determine the prevalence of work-related upper limbs symptoms (WRULS) among office workers and factors associated with it. A self-administered questionnaire was used to collect the information. A total of 463 (87.7%) office workers from selected government agencies participated in this study. The mean age of the respondents was 34.1 years (range = 18-55 years). Majority (91.6%) were Malay and female (72.8%), and 58.1% were from clerical group. Mean duration of work was 8.7 years. This study found that prevalence of WRULS was 33.0% (95% CI [confidence interval] = 28.8%, 37.3%). Computer users at work had 2.0 (95% CI = 1.1, 3.4) higher odds ratio of developing WRULS and those who used it for 5 hours and more per day had 7.5 (95% CI = 2.3, 24.2) higher odds ratio of developing WRULS. Hand-intensive hobbies and higher education were also found to be associated with WRULS.

Matched MeSH terms: Adolescent

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