MyMedR

Fulltext Aerosol-generating procedures in thoracic surgery in the COVID-19 era in Malaysia

Sathiamurthy N, Balasubbiah N, Dharmaraj B

Asian Cardiovasc Thorac Ann, 2020 Oct;28(8):495-499.

PMID: 32787442 DOI: 10.1177/0218492320950898

BACKGROUND: The Covid-19 pandemic has caused changes in the surgical treatment of non-Covid patients, especially in thoracic surgery because most procedures are aerosol generating. Hospital Kuala Lumpur, where thoracic procedures are performed, was badly affected. We describe our experience in performing aerosol generating procedures safely in thoracic surgery during the Covid-19 era.

METHODS: Medical records of patients who underwent thoracic surgery from March 18, 2020 to May 17, 2020 were reviewed retrospectively. All patients undergoing thoracic surgery were tested for Covid-19 using the reverse transcriptase polymerase chain reaction method. Patients with malignancy were observed for 10 to 14 days in the ward after testing negative. The healthcare workers donned personal protective equipment for all the cases, and the number of healthcare workers in the operating room was limited to the minimum required.

RESULTS: A total of 44 procedures were performed in 26 thoracic surgeries. All of these procedures were classified as aerosol generating, and the mean duration of the surgery was 130 ± 43 minutes. None of the healthcare workers involved in the surgery were exposed or infected by Covid-19.

CONCLUSION: Covid-19 will be a threat for a long time and thoracic surgeons must continue to provide their services, despite having to deal with aerosol generating procedures, in the new normal. Covid-19 testing of all surgical candidates, using the reverse transcriptase polymerase chain reaction, donning full personal protective equipment for healthcare workers, and carefully planned procedures are among the measures suggested to prevent unnecessary Covid-19 exposure in thoracic surgery.

Matched MeSH terms: Pneumonia, Viral/diagnosis; Pneumonia, Viral/epidemiology; Pneumonia, Viral/prevention & control*

Mycobacterium smegmatis proteoliposome induce protection in a murine progressive pulmonary tuberculosis model

Tirado Y, Puig A, Alvarez N, Borrero R, Aguilar A, Camacho F, et al.

Tuberculosis (Edinb), 2016 12;101:44-48.

PMID: 27865396 DOI: 10.1016/j.tube.2016.07.017

Tuberculosis (TB) remains an important cause of mortality and morbidity. The TB vaccine, BCG, is not fully protective against the adult form of the disease and is unable to prevent its transmission although it is still useful against severe childhood TB. Hence, the search for new vaccines is of great interest. In a previous study, we have shown that proteoliposomes obtained from Mycobacterium smegmatis (PLMs) induced cross reactive humoral and cellular response against Mycobacterium tuberculosis (Mtb) antigens. With the objective to evaluate the protective capability of PLMs, a murine model of progressive pulmonary TB was used. Animals immunized with PLMs with and without alum (PLMs/PLMsAL respectively) showed protection compared to non-immunized animals. Mice immunized with PLMsAL induced similar protection as that of BCG. Animals immunized with BCG, PLMs and PLMsAL showed a significant decrease in tissue damage (percentage of pneumonic area/lung) compared to non-immunized animals, with a more prominent effect in BCG vaccinated mice. The protective effect of the administration of PLMs in mice supports its future evaluation as experimental vaccine candidate against Mtb.

Matched MeSH terms: Pneumonia, Bacterial/microbiology; Pneumonia, Bacterial/pathology; Pneumonia, Bacterial/prevention & control

Fulltext An unusual case of primary melioidotic prostatic abscess complicated by perianal abscess

Chee YC, Chee YN

IDCases, 2018;11:51-52.

PMID: 29349040 DOI: 10.1016/j.idcr.2018.01.001

Burkholderia pseudomallei is recognized to cause severe and fatal infections. Most of the infections caused by this facultative intracellular gram-negative bacterium are pneumonia, soft tissue, genito-urinary and central nervous system infection. We report an unusual case of primary prostatic abscess complicated by perianal abscess caused by Burkholderia pseudomallei. Melioidosis related anorectal infections have not been previously reported in the literature.

Matched MeSH terms: Pneumonia

Fulltext A review on chitosan and its development as pulmonary particulate anti-infective and anti-cancer drug carriers

Rasul RM, Tamilarasi Muniandy M, Zakaria Z, Shah K, Chee CF, Dabbagh A, et al.

Carbohydr Polym, 2020 Dec 15;250:116800.

PMID: 33049807 DOI: 10.1016/j.carbpol.2020.116800

Chitosan, as a biodegradable and biocompatible polymer, is characterized by anti-microbial and anti-cancer properties. It lately has received a widespread interest for use as the pulmonary particulate backbone materials of drug carrier for the treatment of infectious disease and cancer. The success of chitosan as pulmonary particulate drug carrier is a critical interplay of their mucoadhesive, permeation enhancement and site/cell-specific attributes. In the case of nanocarriers, various microencapsulation and micro-nano blending systems have been devised to equip them with an appropriate aerodynamic character to enable efficient pulmonary aerosolization and inhalation. The late COVID-19 infection is met with acute respiratory distress syndrome and cancer. Chitosan and its derivatives are found useful in combating HCoV and cancer as a function of their molecular weight, substituent type and its degree of substitution. The interest in chitosan is expected to rise in the next decade from the perspectives of drug delivery in combination with its therapeutic performance.

Matched MeSH terms: Pneumonia, Viral/drug therapy; Pneumonia, Viral/pathology; Pneumonia, Viral/virology

The effect of chlorhexidine in reducing oral colonisation in geriatric patients: a randomised controlled trial

Sharif-Abdullah SS, Chong MC, Surindar-Kaur SS, Kamaruzzaman SB, Ng KH

Singapore Med J, 2016 May;57(5):262-6.

PMID: 27211885 DOI: 10.11622/smedj.2016091

INTRODUCTION: Inadequate oral care has been implicated in the development of aspiration pneumonia in frail geriatric patients and is a major cause of mortality, due to the colonisation of microbes in vulnerable patients. This type of pneumonia has been associated with an increase in respiratory pathogens in the oral cavity. The aim of this study was to evaluate the effects of chlorhexidine compared to routine oral care in edentulous geriatric inpatients.

METHODS: A double-blind, parallel-group randomised controlled trial was carried out. The intervention group received oral care with chlorhexidine 0.2%, while the control group received routine oral care with thymol. Nurses provided oral care with assigned solutions of 20 mL once daily over seven days. Oral cavity assessment using the Brief Oral Health Status Examination form was performed before each oral care procedure. Data on medication received and the subsequent development of aspiration pneumonia was recorded. An oral swab was performed on Day 7 to obtain specimens to test for colonisation.

RESULTS: The final sample consisted of 35 (control) and 43 (intervention) patients. Chlorhexidine was effective in reducing oral colonisation compared to routine oral care with thymol (p < 0.001). The risk of oral bacterial colonisation was nearly three times higher in the thymol group compared to the chlorhexidine group.

CONCLUSION: The use of chlorhexidine 0.2% significantly reduced oral colonisation and is recommended as an easier and more cost-effective alternative for oral hygiene.

Matched MeSH terms: Pneumonia, Aspiration/microbiology; Pneumonia, Aspiration/prevention & control*; Pneumonia, Ventilator-Associated

Fulltext Research on the treatment of Pseudomonas aeruginosa pneumonia in children by macrolide antibiotics

Huang XQ, Deng L, Lu G, He CH, Wu PQ, Xie ZW, et al.

Open Med (Wars), 2015;10(1):479-482.

PMID: 28352740 DOI: 10.1515/med-2015-0082

To observe a therapeutic effect of macrolide antibiotics in children with Pseudomonas aeruginosa pneumonia. Fifty-four cases of children with Pseudomonas aeruginosa pneumonia were randomly divided into an observation group (n=30) and a control group (n=24). The observation group was treated with macrolide antibiotics and cefoperazone/sulbactam. The control group was treated with cefoperazone/sulbactam during a course of 10-14 days. The total effective rate was 93.3% in the observation group, and 58.3% in the control group, and results in the observation group were superior to the control group notably (P>0.05). There were no significant differences in bacterial clearance rate, adverse reaction rate between two groups (P>0.05). The combined application of cefoperazone/sulbactam with macrolide antibiotics to treat Pseudomonas aeruginosa pneumonia in children would be a more effective clinical method.

Matched MeSH terms: Pneumonia

Fulltext Schwartz rounds for healthcare personnel in coping with COVID-19 pandemic

Saniasiaya J, Ramasamy K

Postgrad Med J, 2020 Jul;96(1137):425.

PMID: 32345755 DOI: 10.1136/postgradmedj-2020-137806

Matched MeSH terms: Pneumonia, Viral

Fulltext Natural Flavonoids as Potential Angiotensin-Converting Enzyme 2 Inhibitors for Anti-SARS-CoV-2

Muchtaridi M, Fauzi M, Khairul Ikram NK, Mohd Gazzali A, Wahab HA

Molecules, 2020 Sep 01;25(17).

PMID: 32882868 DOI: 10.3390/molecules25173980

Over the years, coronaviruses (CoV) have posed a severe public health threat, causing an increase in mortality and morbidity rates throughout the world. The recent outbreak of a novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the current Coronavirus Disease 2019 (COVID-19) pandemic that affected more than 215 countries with over 23 million cases and 800,000 deaths as of today. The situation is critical, especially with the absence of specific medicines or vaccines; hence, efforts toward the development of anti-COVID-19 medicines are being intensively undertaken. One of the potential therapeutic targets of anti-COVID-19 drugs is the angiotensin-converting enzyme 2 (ACE2). ACE2 was identified as a key functional receptor for CoV associated with COVID-19. ACE2, which is located on the surface of the host cells, binds effectively to the spike protein of CoV, thus enabling the virus to infect the epithelial cells of the host. Previous studies showed that certain flavonoids exhibit angiotensin-converting enzyme inhibition activity, which plays a crucial role in the regulation of arterial blood pressure. Thus, it is being postulated that these flavonoids might also interact with ACE2. This postulation might be of interest because these compounds also show antiviral activity in vitro. This article summarizes the natural flavonoids with potential efficacy against COVID-19 through ACE2 receptor inhibition.

Matched MeSH terms: Pneumonia, Viral/drug therapy; Pneumonia, Viral/epidemiology; Pneumonia, Viral/virology*

Appropriate Antibiotic Administration in Critically Ill Patients with Pneumonia

Khan RA, Bakry MM, Islahudin F

Indian J Pharm Sci, 2015 7 17;77(3):299-305.

PMID: 26180275

Inappropriate initial antibiotics for pneumonia infection are usually linked to extended intensive care unit stay and are associated with an increased risk of mortality. This study evaluates the impact of inappropriate initial antibiotics on the length of intensive care unit stay, risk of mortality and the co-predictors that influences these outcomes. This retrospective study was conducted in an intensive care unit of a teaching hospital. The types of pneumonia investigated were hospital-acquired pneumonia and ventilator-associated pneumonia. Three different time points were defined as the initiation of appropriate antibiotics at 24 h, between 24 to 48 h and at more than 48 h after obtaining a culture. Patients had either hospital-acquired pneumonia (59.1%) or ventilator-associated pneumonia (40.9%). The length of intensive care unit stay ranged from 1 to 52 days (mean; 9.78±10.02 days). Patients who received appropriate antibiotic agent at 24 h had a significantly shorter length of intensive care unit stay (5.62 d, P<0.001). The co-predictors that contributed to an extended intensive care unit stay were the time of availability of susceptibility results and concomitant diseases, namely cancer and sepsis. The only predictor of intensive care unit death was cancer. The results support the need for early appropriate initial antibiotic therapy in hospital-acquired pneumonia and ventilator-associated pneumonia infections.

Matched MeSH terms: Pneumonia, Ventilator-Associated

Fulltext Pneumonia in the tropics: Report from the Task Force on tropical diseases by the World Federation of Societies of Intensive and Critical Care Medicine

Nor MBM, Richards GA, McGloughlin S, Amin PR, Council of the World Federation of Societies of Intensive and Critical Care Medicine

J Crit Care, 2017 Dec;42:360-365.

PMID: 29129538 DOI: 10.1016/j.jcrc.2017.11.004

The aetiology of community acquired pneumonia varies according to the region in which it is acquired. This review discusses those causes of CAP that occur in the tropics and might not be readily recognizable when transplanted to other sites. Various forms of pneumonia including the viral causes such as influenza (seasonal and avian varieties), the coronaviruses and the Hantavirus as well as bacterial causes, specifically the pneumonic form of Yersinia pestis and melioidosis are discussed.

Matched MeSH terms: Pneumonia, Bacterial/diagnosis*; Pneumonia, Bacterial/microbiology; Pneumonia, Bacterial/therapy

Fulltext Cardiovascular Disease and Use of Renin-Angiotensin System Inhibitors in COVID-19

Kow CS, Zaidi STR, Hasan SS

Am J Cardiovasc Drugs, 2020 Jun;20(3):217-221.

PMID: 32281055 DOI: 10.1007/s40256-020-00406-0

There is ongoing debate on the safety of renin-angiotensin system (RAS) inhibitors in COVID-19. Recently published studies highlight a potential relationship between cardiovascular disease (CVD) and COVID-19. This article aims to summarize the evidence on the use of RAS inhibitors in CVD patients with COVID-19, focusing on safety issues of the RAS inhibitors and their relationship with COVID-19.

Matched MeSH terms: Pneumonia, Viral/diagnosis; Pneumonia, Viral/metabolism; Pneumonia, Viral/epidemiology

Fulltext Oral care practice for the ventilated patients in intensive care units: a pilot survey

Soh KL, Shariff Ghazali S, Soh KG, Abdul Raman R, Sharif Abdullah SS, Ong SL

J Infect Dev Ctries, 2012 Apr;6(4):333-9.

PMID: 22505443

INTRODUCTION: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in intensive care units (ICUs). One factor causing VAP is aspiration of oral colonisation, which may result from poor oral care practice. Oral care using tooth brushing can prevent formulation of dental plaque that can be a reservoir for microbes causing VAP.
METHODOLOGY: A cross-sectional survey was conducted among 124 nurses, using a self-administered questionnaire, to determine methods used, frequency, and attitude of nurses toward oral care provided to mechanically ventilated patients in Malaysian ICUs.
RESULTS: Methods for oral care and their frequency of use varied between nurses even in the same unit. Cotton with forceps was used by 73.4% of the nurses. Some nurses used forceps and gauze (65%) or spatulas and gauze (36%). Toothbrushes were used by 50.8% of the nurses. Nurses in this hospital reported to have positive attitude toward providing oral care.
CONCLUSIONS: The survey showed the need to have standardised oral care protocols in ICUs to improve quality of oral care provided to ventilated patients.

Matched MeSH terms: Pneumonia, Ventilator-Associated/prevention & control*

Childhood pneumonia: a neglected, climate-sensitive disease?

Paynter S, Ware RS, Weinstein P, Williams G, Sly PD

Lancet, 2010 Nov 27;376(9755):1804-5.

PMID: 21111894 DOI: 10.1016/S0140-6736(10)62141-1

Matched MeSH terms: Pneumonia/epidemiology*

Nurses' perceptions of standardised assessment and prevention of complications in an ICU

Soh KL, Davidson PM, Leslie G, DiGiacomo M, Soh KG

J Clin Nurs, 2013 Mar;22(5-6):856-65.

PMID: 23398314 DOI: 10.1111/jocn.12017

To describe nurses' perceptions of evidence-based recommendations to prevent complications in a Malaysian intensive care unit.

Matched MeSH terms: Pneumonia, Ventilator-Associated/prevention & control*

The sequelae of barium aspiration

Gendeh HS, Hashim ND, Mohammad Yunus MR, Gendeh BS, Kosai NR

ANZ J Surg, 2018 09;88(9):937-938.

PMID: 27122196 DOI: 10.1111/ans.13624

Matched MeSH terms: Pneumonia, Aspiration/etiology*

Community-acquired pneumonia in patients requiring hospitalization

Liam CK, Lim KH, Wong CM

Respirology, 2001 Sep;6(3):259-64.

PMID: 11555386

This study aimed to investigate the microbial aetiology of community-acquired pneumonia (CAP) in patients requiring hospitalization.

Matched MeSH terms: Pneumonia/microbiology*

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: Pneumonia, Bacterial/etiology*

Fulltext Adult varicella pneumonia that responded to combined acyclovir and steroid therapy

Lau LG

Med J Malaysia, 1999 Jun;54(2):270-2.

PMID: 10972042

We describe a case of adult chickenpox which was complicated by severe varicella pneumonia, mild hepatitis and thrombocytopenia. The hepatitis and the thrombocytopenia were asymptomatic clinically and were diagnosed on biochemistry and blood count results. These eventually improved without specific interventions. The pneumonia, however, deteriorated rapidly despite the early commencement of oxygen supplementation, acyclovir and antibiotic. Subsequently, systemic corticosteroid therapy was initiated and the patient was ventilated in the intensive care unit. The patient eventually recovered.

Matched MeSH terms: Pneumonia, Viral/drug therapy*

Fulltext A comparison of sodium citrate and sodium citrate/ranitidine combination for acid aspiration prophylaxis

Chan YK

Med J Malaysia, 1992 Mar;47(1):27-30.

PMID: 1387445

The effectiveness of sodium citrate and sodium citrate/ranitidine were compared in two randomised groups of elective caesarean patients during the various phases of anaesthesia. The mean pH values (3.5, 3.3, 3.6) were lower in the citrate group compared to the citrate/ranitidine group (6.1, 6.3, 5.9). The percentage of patients with pH values less than 2.5 was 40% in the citrate group compared to 7% in the citrate/ranitidine group. Sodium citrate alone is less effective than sodium citrate/ranitidine for acid aspiration prophylaxis.

Matched MeSH terms: Pneumonia, Aspiration/prevention & control*

Spectrum of nocardiosis in renal patients

Kong NC, Morad Z, Suleiman AB, Cheong IK, Lajin I

Ann Acad Med Singap, 1990 May;19(3):375-9.

PMID: 2393240

Nocardiosis is an increasingly recognised opportunistic infection in immunologically incompetent hosts but diagnosis is often delayed. Between December 1975 to October 1988, our two Nephrology Units have encountered five cases of nocardiosis occurring in two post-renal transplant patients, two patients with systemic lupus erythematous (SLE) and one patient with mesangiocapillary glomerulo--nephritis. All were on immunosuppressants at the time. The first three patients presented with predominant pulmonary disease and were cured by combined trimethoprim-sulphamethoxazole (cotrimoxazole) and doxycycline therapy. The patient with limited skin involvement responded to cotrimoxazole alone. However, the last patient with lymphocutaneous disease initially responded to cotrimoxazole (+ chloramphenicol) but developed acute-on-chronic renal failure and relapsed with dose reduction of cotrimoxazole. Alternative treatment with amikacin and doxycycline was instituted with good response. We shall review potential clues that may suggest the diagnosis of nocardiosis and discuss other effective antimicrobial agents.

Matched MeSH terms: Pneumonia/complications*

Displaying publications 241 - 260 of 469 in total