MyMedR

Implantation metastasis in a 13-year-old girl: a case report

Singh C, Ibrahim S, Pang KS, Shanti S

J Orthop Surg (Hong Kong), 2003 Jun;11(1):94-6.

We report a case of a 13-year-old girl with an osteosarcoma of the right humerus, which had been diagnosed as an aneurysmal bone cyst at our institution. She underwent curettage and bone grafting of the lesion, which resulted in implantation metastasis of the tumour to the ilium. She died 15 months after presentation owing to pulmonary metastases. This report highlights the possibility of metastasis occurring by direct implantation to a graft donor site. We strongly recommend that a biopsy be performed in cases of presumed benign lesions before proceeding with the definitive surgery.

Matched MeSH terms: Adolescent

Bone in the eye

Jumaat BH, Dahalan A, Mohamad M

Am J Ophthalmol, 2003 Feb;135(2):254-6.

PMID: 12566045

PURPOSE: To report a case of choroidal osteoma presenting with massive subretinal hemorrhage not associated with choroidal neovascularisation (CNV).

DESIGN: Case report.

METHODS: An 18-year-old man presented with sudden loss of vision in the right eye following competitive swimming. He was found to have a massive subretinal hemorrhage involving the macula.

RESULTS: Following resolution of the hemorrhage, the patient was found to have an underlying choroidal osteoma. There was no evidence of choroidal neovascularisation clinically and angiographically. He regained his normal vision.

CONCLUSIONS: Choroidal osteoma presenting with massive subretinal hemorrhage not associated with underlying choroidal neovascularization need not result in poor visual outcome.

Matched MeSH terms: Adolescent

Fulltext A preliminary study of the influence of HIV infection in the transmission of tuberculosis

Mohammad Z, Naing NN, Salleh R, Ahmad N, Hamzah WM, Mahmud R

Southeast Asian J. Trop. Med. Public Health, 2002 Mar;33(1):92-8.

PMID: 12118468

The human immunodeficiency virus (HIV) epidemic has had a profound influence on the epidemiology of tuberculosis (TB). The potential for HIV-associated TB cases to transmit M. tuberculosis and to produce a secondary increase in TB morbidity is unknown. A cross-sectional study was carried out to compare the prevalence of M. tuberculosis infection among the household contacts of HIV-positive and HIV-negative pulmonary tuberculosis (PTB) patients. Records of tuberculin (Mantoux) tests administered during routine contact investigations at the Chest Clinic, Hospital Kota Bharu, from 1999 to 2000 were reviewed. The HIV status of the patients was based on the results of ELISA tests while information on household contacts was gathered during visits to their houses. Ninety-four contacts of 39 HIV-negative patients and 44 contacts of 17 cases of HIV-positive patients were included in this preliminary study. 30% (12/40) of the contacts of HIV-positive PTB had a positive tuberculin compared with 52.8% (47/ 94) of the contacts of HIV-negative patients [OR = 0.41, 95% Confidence interval (CI) 0.17 - 0.97; p = 0.016]. The difference was still significant after performing multivariate logistic regression analysis to adjust for variables associated with infectiousness of TB (adjusted OR = 0.24, 95% CI 0.07 - 0.87; p = 0.03). This study has shown that HIV-infected PTB patients are less infectious to their contacts than HIV-negative patients. The presence of MV in the community may not necessitate a change of the current policy of the management of contacts.
Study site: Chest Clinic, Hospital Kota Bharu, Kelantan, Malaysia

Matched MeSH terms: Adolescent

Fulltext A study on community acquired pneumonia in adults requiring hospital admission in Penang

Hooi LN, Looi I, Ng AJ

Med J Malaysia, 2001 Sep;56(3):275-84.

PMID: 11732071

A study was carried out to determine the pattern of microbiological organisms causing community acquired pneumonia in adult patients admitted to Penang Hospital between November 1999 and August 2000. Altogether, 98 patients (64 males, 34 females) with a mean age (+/- S.D.) of 55.9 (+/- 19.0) (range 15 to 87) years were included in the study. Causative organisms were identified in 42 patients (42.9%). Mycobacterium tuberculosis was the commonest pathogen being identified in 15.3% of cases, followed by Klebsiella pneumoniae (7.2%), Pseudomonas aeruginosa (6.1%) and Staphylococcus aureus (5.1%). Streptococcus pneumoniae and Acinetobacter spp accounted for 3 cases each (3.1%) and Haemophilus influenzae, non-haemolytic Streptococcus, Mycoplasma pneumoniae, Salmonella typhi, Escherichia coli, Klebsiella spp and Pseudomonas spp for 1 case each (1.0%). Four patients (4.1%) had dual infections and no case of legionella pneumonia was found in this series.

Matched MeSH terms: Adolescent

Fulltext Lamotrigine as an add-on therapy in intractable paediatric epilepsy--the Kuala Lumpur Hospital experience

Vigneswari G, Sofiah A, Hussain IHMI

Med J Malaysia, 2001 Sep;56(3):359-64.

PMID: 11732083

An observational study of all children with intractable epilepsy at the Paediatric Institute prescribed Lamotrigine as an add-on therapy between January 1994 and November 1998 was conducted. A total of 30 children were recruited. Three had adverse effects to the drug and it was withdrawn. Of the remaining 27, there were 20 boys and 7 girls, ranging from 2 to 17 years. Fifteen children had generalised epilepsy, 6 had partial epilepsy, 2 had West syndrome and 4 had Lennox Gastaut syndrome. Six children (20%) became seizure free, and 14 (54%) had a greater than 50% reduction in seizure frequency. However 7 children (23%) did not respond and 3 experienced a deterioration in seizure severity. Nine children were noted to have an improvement in alertness and behaviour. Our small series suggests that Lamotrigine is useful as add-on therapy in childhood intractable epilepsy.

Matched MeSH terms: Adolescent

Fulltext Traumatic transection of aorta

Ho CK, Yip KT, Eng JB, Rajan L, Tan BH

Med J Malaysia, 2001 Sep;56(3):374-7.

PMID: 11732086

A 16 year-old man presented with fracture of both his femurs after a road traffic accident. Chest radiograph revealed mediastinal widening. Subsequent CT scan and arch aortogram confirmed the findings of traumatic aortic arch transection at the isthmus. He underwent successful surgical repair. High index of suspicion and prompt actions are important in managing this potentially fatal but treatable condition.

Matched MeSH terms: Adolescent

Fulltext Clinical features of malaria in Orang Asli population in Pos Piah, Malaysia

Norhayati M, Rohani AK, Hayati MIN, Halimah AS, Sharom MY, Zainah Abidin AH, et al.

Med J Malaysia, 2001 Sep;56(3):271-4.

PMID: 11732070

A malaria survey was conducted to examine the presence of common clinical features of malaria in individuals living in an endemic area of malaria. The overall infection rate was 11.0% with 7.5% and 3.5% infected with Plasmodium vivax and Plasmodium falciparum respectively. The mean parasitaemia level of both species was 2905.9 parasites/microliter blood, with the mean parasitaemia level of P. vivax and P. falciparum at 682.7 parasites/microliter blood and 6981.7 parasites/microliter blood respectively. The infection rates were higher in the younger age group. Hepatomegaly, hepatosplenomegaly and clinical anaemia were significantly associated with malaria. None of the patients were febrile. In conclusion, in low endemic areas, the presence of clinical anaemia, hepatomegaly and hepatosplenomegaly in afebrile individuals could be considered as useful criteria for the presence of asymptomatic parasitaemia. It is important to carry out laboratory diagnostic investigations, to ensure all the asymptomatic parasitaemia which act as reservoirs are detected and treated.

Matched MeSH terms: Adolescent

Fulltext A successful pregnancy outcome in treated vulval rhabdomyosarcoma

Ariza M, Rafaee T, Adeeb N, Muhaizan WM, Isa MR

Med J Malaysia, 1999 Sep;54(3):371-3.

PMID: 11045067

A 14 year old girl presented in 1986 with a huge perineal swelling which was progressively increasing in size and associated with loss of weight and loss of appetite. Biopsy from the mass revealed rhabdomyosarcoma of the vulva. She was treated with chemotherapy and radium implant. She responded well to the regime. Fibrosis of the vulva and vagina caused difficulty in consummation. Once it was corrected, she conceived easily and proceeded to a normal pregnancy and delivery.

Matched MeSH terms: Adolescent

Fulltext Hepatitis B surface antigen subtypes in hepatitis B seropositive subjects in University Hospital, Kuala Lumpur

Ng KP, Saw TL

Med J Malaysia, 1999 Sep;54(3):352-7.

PMID: 11045062

Hepatitis B surface antigen can be serologically defined as ayw1, ayw2, ayw3, ayw4, ayr, adw2, adw4 and adrq+ or adrq-. A study of common HBsAg subtypes in 44 HBsAg reactive sera in University Hospital was conducted using a solid-phase sandwich EIA. Eleven samples were found not typable and among the 33 typable HBsAg reactive sera, 3 HBsAg subtypes: adw, adr and ayw were identified. Subtype adw was found in 66.7% (22/33) of the typable HBsAg reactive sera; 24.2% (8/33) was of subtype adr and 6.0% (2/33) of subtype ayw. One sample was found to be reactive to both adw and adr. HBsAg subtype adw was found more commonly in Chinese but among the Malays, HBsAg subtype adr appeared to predominate. However, the small sample size precludes firm conclusions on the predominant subtype among the Malays.

Matched MeSH terms: Adolescent

Fulltext Amoebiasis: a 10 year retrospective study at the University Hospital, Kuala Lumpur

Jamaiah I, Shekhar KC

Med J Malaysia, 1999 Sep;54(3):296-302.

PMID: 11045054

A hospital based retrospective study of amoebiasis was carried out for a ten-year period at the University Hospital, Kuala Lumpur. Of the 51 cases traced, 30 (59%) had amoebic dysentery, 20 (39%) were amoebic liver abscess (ALA) and one patient had both conditions. Entameoba histolytica trophozoites were identified in 13 (43%) of the amoebic dysenteric stools and 9 (30%) from biopsy. Of the 20 (39%) ALA cases, only one showed parasites in the stool and biopsy. Majority of the patients with dysentery were Malays while Chinese comprised 40% with ALA. Males predominated overall with a male female ratio of 3:1, while for ALA it was 9:1. Most of ALA were single (71.4%) and were localised in the right lobe. The majority of the patients were unemployed. Eighty three percent (83%) of the patients presented with diarrhoea or dysentery followed by abdominal pain while those with ALA had fever, chills, rigors and pain in the right hypochondrium. Eighty percent of the ALA cases showed hepatomegaly. All patients responded to treatment with metronidazole.

Matched MeSH terms: Adolescent

Fulltext Epidemiology of head injury in Malaysian children: a hospital-based study

Rohana J, Ong LC, Abu Hassan AA

Med J Malaysia, 1998 Sep;53(3):217-22.

PMID: 10968156

A prospective observational study was carried out at the Emergency Department, Hospital Kuala Lumpur to determine the proportion of accidental head injury among children and the circumstances of injury. The study was carried out from November 1993 to January 1994 on all children below 14 years who presented to the Emergency Department with accidental head injury. Accidental head injury made up (4.75%) of all cases seen at the Casualty Department. The ratio of boys to girls was 2:1. The mean age of head injured children was 5.2 (S.D. 3.63) years. The leading cause of head injury was fall (63%) followed by road traffic accidents (RTA) in (30.7%) while the rest were due to 'impact' (injury caused by flying object or missiles) injuries. More than half (54.4%) of those injured in RTA were pedestrians. Pedestrian injury was particularly important in the 5-< 14 years age group, where adult supervision was lacking in two thirds of the children. None of the patients who were involved in vehicle-related injuries had used a suitable protective or restraining device. All three patients who died were from this group. This study emphasises the need for stricter enforcement of laws related to the use of protective devices and measures to decrease child pedestrian injury. The issues of lack of adult supervision, both in and outside the home need to be addressed.

Matched MeSH terms: Adolescent

Fulltext Patterns of post-operative analgesic usage in adults and children

Rus-Anida A, Quah BS

Med J Malaysia, 1998 Sep;53(3):204-8.

PMID: 10968154

There appears to be a general tendency towards under-usage of analgesics not only in children but also in adults. The aim of this study was to describe the pattern of analgesic usage in adults and children admitted for major intra-abdominal surgery. All patients who had intra-abdominal surgery at University Science Malaysia Hospital (USM Hospital) from 1st January to 31st March 1995 were included in the study. Children were patients of 12 years and below and adults were patients above 12 years of age. Data including age, sex, weight, type of analgesics used, the number of patients who had analgesics ordered and administered post-operatively were obtained from the patients' medical record. A total of 48 children and 67 adults were studied. Narcotic analgesics were the most common analgesics ordered both in adults (95.5%) and in children (97%). Post-operative analgesics were ordered significantly more often for adults 67 (100%) than for children 33 (69%) (p < 0.0001). In adults, 70% of patients who had analgesics ordered post-operatively had their analgesics administered, but in children only 39.4% of patients had their analgesics administered (p < 0.001). The most common route of administration was intramuscular in both adults (95.5%) and children (88%). Analgesics were more likely to be administered in the intensive care units (100%) than in the surgical wards (60%) (p = 0.049). Elective or emergency surgery and the time of day when surgery was performed did not affect the frequency of analgesics ordered or administered. In summary, children in this hospital had less analgesics ordered and administered following intra-abdominal surgery compared to adults. The results of this study imply that increased attention should be given to relieve postoperative pain with analgesic drugs in children.

Matched MeSH terms: Adolescent

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: Adolescent

Use of bovine xenograft in reconstruction of traumatic anterior cranial fossa bone defects involving the frontal sinus

Abdullah J, Rushdan A, Hamzah M, Ariff AR, Rani A

Ann. Transplant., 1999;4(3-4):28-31.

PMID: 10853777

Four patients underwent reconstruction of anterior cranial fossa of skull defects between November 1997 and January 1998. All of them had traumatic anterior cranial fossa defect and were reconstructed with lyophilised bovine cortical bone graft. There was no cerebrospinal fluid leakage, meningitis, extradural abscess or other infections. This study demonstrates that the use of bovine bone graft in the reconstruction of anterior base defects is safe.

Matched MeSH terms: Adolescent

Fulltext Bacterial enteropathogens isolated in childhood diarrhoea in Kuala Lumpur--the changing trend

Lee WS, Puthucheary SD

Med J Malaysia, 2002 Mar;57(1):24-30.

PMID: 14569714

A retrospective review of all stool samples obtained from children aged < 16 years with diarrhoea from University of Malaya Medical Centre (UMMC), Kuala Lumpur, from 1978 to 1997 was undertaken to ascertain the pattern of bacterial pathogens causing diarrhoea in children in an urban area in Malaysia. Of 26444 stool samples processed, 2989 (11%) were positive. The five most common bacterial pathogens isolated were non-typhoidal Salmonella (57%), enteropathogenic E. coli (EPEC) (14%), Shigella spp. (11%), Campylobacter spp. (5%) and Aeromonas spp. (4%). There was a significant reduction in the average percentage of positive isolation during the last 5 years of the study period as compared to the first 5 years (15.0% vs. 7.2%; r = -0.92, p = 0.0001). EPEC and Shigella spp. were less commonly isolated in the last five years compared with the first five years of the study (6% vs 21% p < 0.001 for E. coli; 7% vs 22%, p < 0.001 for Shigella spp.). This information is important for public health education in reducing the incidence of childhood diarrhoea further, and in the selection of appropriate antimicrobials in the management of extra-intestinal complications of childhood diarrhoea.

Matched MeSH terms: Adolescent

Weight loss practices among Malaysian adults

Kong WT, Chua SS, Alwi S

Asia Pac J Public Health, 2002;14(2):99-104.

PMID: 12862414 DOI: 10.1177/101053950201400208

The practice of losing weight is gaining popularity globally with an increase in health consciousness among the general public. A survey was conducted in seven shopping centres in Kuala Lumpur and its neighbouring towns to assess the weight-loss practices of the general public. Out of the 1032 people approached by the researcher, 389 (37.7%) admitted that they had tried to lose weight before. Of these respondents, 50.4% had the wrong perceptions about their weight with 39.1% of the respondents having BMI lower than what they had perceived. The most common weight-loss method used was dieting (89.5%), followed by exercise (81%) and the use of slimming teas (24.9%). Exercise (79.0%) was perceived as the most effective method for losing weight, followed by dieting (71.6%). Most respondents (60.6%) obtained their weight-loss products from the pharmacies but only 34.9% of these respondents had consulted the pharmacists on these products. Therefore, pharmacists should play a more active role in assisting the general public to lose weight successfully and safely.

Matched MeSH terms: Adolescent

Fulltext Libido, sexuality and the levonorgestrel IUS in Malaysia

Wong CY

J Fam Plann Reprod Health Care, 2001 Jan;27(1):56.

PMID: 12457552 DOI: 10.1783/147118901101194976

Hysterectomy and tubal sterilisation are two commonly performed gynaecological procedures in Malaysia. Little has been published about the psychological impact on sexuality of such operations in the Far East. Many Malaysian patients believe that surgery to the pelvic organs may be detrimental to the sexual health and needs of women. There is a widespread belief that the uterus is essential for the libido and sexual wellbeing of women. It is also believed that tubal sterilisation may result in the loss of libido and thus of sexual desire for her husband. Despite counselling to dispel these misconceptions, patients frequently refuse surgical management for fear of losing their libido and sexuality. Inability to satisfy and consummate marriage is a valid reason for the partner to find another wife (Muslims in Malaysia are legally allowed to have four wives). This fear of ultimately losing the husband to another woman due to lack of libido and loss of sexuality often causes women to refuse appropriate surgery. The recent availability of the levonorgestrel intra-uterine system (IUS) in Malaysia provides a suitable medical alternative to surgery in managing some of these patients. There is good evidence to suggest the effectiveness of the levonorgestrel IUS in the treatment of menorrhagia. The use of the levonorgestrel IUS in women whose cultural beliefs/misconceptions are not amenable to counselling, may help in the psychological preservation of their libido and sexuality.

Matched MeSH terms: Adolescent

Forest fires, air pollution, and mortality in southeast Asia

Sastry N

Demography, 2002 Feb;39(1):1-23.

PMID: 11852832

I assess the population health effects in Malaysia of air pollution from a widespread series of fires that occurred in Indonesia between April and November of 1997. I describe how the fires occurred and why the associated air pollution was so widespread and long lasting. The main objective is to uncover any mortality effects and to assess how large and important they were. I also investigate whether the mortality effects were persistent or whether they represented a short-term, mortality-harvesting effect. The results show that the smoke haze from the fires had a deleterious effect on the health of the population in Malaysia.

Matched MeSH terms: Adolescent

Fulltext Comparison of safety and immunogenicity of a Vi polysaccharide typhoid vaccine with a whole-cell killed vaccine in Malaysian Air Force recruits

Panchanathan V, Kumar S, Yeap W, Devi S, Ismail R, Sarijan S, et al.

Bull World Health Organ, 2001;79(9):811-7.

PMID: 11584728

To carry out a comparative study of the safety and immunogenicity of Vi polysaccharide vaccine against whole-cell killed (WCK) typhoid vaccine.

Matched MeSH terms: Adolescent

Heterogeneity of the CYP2D6 gene among Malays in Malaysia

Teh LK, Ismail R, Yusoff R, Hussein A, Isa MN, Rahman AR

J Clin Pharm Ther, 2001 Jun;26(3):205-11.

PMID: 11422605

Although Malays shared an origin with Chinese, their evolution saw substantial divergences. Phenotyping studies suggested that they differed in CYP2D6 polymorphism, with higher PM prevalence but lesser right-shift for debrisoquine MRs.

Matched MeSH terms: Adolescent

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