Six patients underwent transcatheter closure of patent ductus arteriosus (PDA) using either conventional Gianturco coils or the Amplatzer Ductal Occluder (ADO) device. All patients were females with a median age of 23.3 (range 4 to 26 years). The mean PDA size measured on the lateral aortogram was 3.81mm (range 2.3-5.83mm). Complete closure of the PDA was achieved in all patients.
A total of 245 foreign workers was screened for various microbial and parasitic infections, as part of the pilot study on the health problems of foreign workers. The sample comprising of Indonesian and Bangladeshi workers, was selected on a non-probability basis from two sources, i.e. University Hospital and a private sector. This investigation revealed substantive number of workers with positive cases to some of the microbial and parasitic infections. KEYWORDS: Pilot study, infective agents, foreign workers
The use of steroid therapy and its treatment impact on children hospitalised with viral croup between 1994-1998 were reviewed by comparing 30 patients who received steroid therapy with 65 patients who did not. There was no difference in the socio-demographic and clinical profile between the two groups. The hospital stay (2.8 ± 1.3 vs 3.5 ± 1.2 days, p = 0.02) and duration of documented stridor (1.3 ±0.5 vs 2.8 ± 1.0 days, p = 0.001) were shorter for patients who received steroid therapy although they appeared to have more severe respiratory distress. There were no complications associated with steroid therapy use. Despite reluctance in administering steroid therapy for viral croup, patients who received the treatment had a shorter hospital stay and duration of stridor. KEYWORDS: Croup, steroid therapy, hospital stay.
Bisphosphonates are synthetic analogues of pyrophosphate. Their main pharmacological effect is to iuhibit bone resorption by a variety of mechanisms, not all of which are clearly understood. The activity of the bisphosphonates varies depending on the compound. In clinical trials, they have been shown to stop postmenopausal bone loss and increase bone density, with a concomitant reduction in fracture rate with some agents. This article reviews the currently known mechanisms of action of the bisphosphonates and the evidence that they are useful in the treatment of osteoporosis.
The Takotsubo syndrome is an acquired, non-ischemic stress-induced cardiomyopathy popularly known as the ‘broken heart syndrome’. It is an acute left ventricular dysfunction presenting mostly in older women after an intensely stressful event. The exact pathophysiology remains elusive. The term came into existence in the early 1990s in Japan, where the distinctive change in the shape of the left ventricle with apical ballooning during systole, resembled the Takotsubo, an octopus pot used bythe Japanese fisherman. From a rare underrecognized syndrome, it has been increasingly recognised as a form of acute cardiac failure. Clinical diagnosis of the syndrome may be unidentified due to its similarity with the acute coronary syndrome, but without the narrowing of coronary vessels in angiographic imaging. There is a substantial elevation of the cardiac biomarkers, troponin and the natriuretic peptides which helps in differentiating the Takotsubo syndrome from myocardial infarction. A case report of a 59-year old Malaysian lady with typical, recurrent episodes of the Takotsubo syndrome is presented.
Background: This paper investigates the quality of life of brain pathology patients in relation to their sociodemographic
profiles and clinical factors.
Methods: This is a cross-sectional study done at a tertiary referral hospital in Kuala Lumpur. A total of 100
patients were recruited in the study after excluding 22 patients who did not met the exclusion criteria. The
European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) self-administered
questionnaire was utilized in the study. The Global health status/QoL, Physical functioning, Role functioning,
Emotional functioning, Cognitive functioning, Social functioning, Fatigue, Nausea and vomiting, Pain, Dyspnoea,
Insomnia, Appetite loss, Constipation, Diarrhoea, and Financial difficulties were assessed in this study.
Results: The most severe impairment in functioning was with lowest score of cognitive functioning (mean
score=61) and the most severe symptom was fatigue (mean score=45). There were significant differences in
quality of life scores in different socio-demographic groupsand types of brain pathology patients. Patients aged
below 40 years old or less had better physical functioning, less symptoms of fatigue and insomnia compared
to patients who were more than 40 years old. Male patients faced more financial difficulties compared with
female patients. Patients who were married had increased insomnia compared to the single patients. Employed
patients had better physical functioning and less financial difficulties compared with patients who were
unemployed. Patients who earned >RM 2500.00 monthly had better physical functioning, less symptoms of pain and less financial difficulties than patients who earned ≤RM 2500.00. Patients with qualifications lower
than SPM tended to face more financial difficulties compared to patients with qualifications of SPM or higher.
Meningioma patients had better social functioning compared with others, whereas Carvenoma patients had
better physical functioning. Meningioma patients had more symptoms of insomnia compared with other
patients. All the findings were with p value less than 0.05.
Conclusion: The quality of life of patients with brain pathology is affected by socio-demographic factors and
clinical diagnoses. Efforts should be made to improve the overall quality of life of these patients.
The aim of this review is to critically analyse the available literature and to propose a rational, safe and cost-effective clinical pathway to provide nutritional support in acute pancreatitis. This pathway is proposed based on assessment of peer reviewed literature and existing generally accepted knowledge. Acute pancreatitis is a heterogeneous disease and the outcome is variable. The role of nutritional support is controversial. Acute mild pancreatitis (80%) usually does not require nutritional support unless the pre-existing nutritional is poor or complications occur. Contrary to this acute severe pancreatitis is associated with severe catabolism and a high complication rate. Nutritional depletion rapidly occurs. It is logical to support the nutrition once the patient is haemodynamically stable. Although enteral nutrition should be administered whenever feasible, it is not always possible or advisable. Aggressive, hypercaloric parenteral nutrition administered via central venous line is not recommended. A combination of initial peripheral parenteral nutrition with fat in appropriate amount, and gradually switching over to enteral feedings is safer and cost-effective. It also avoids central line associated sepsis. The roles of newer specific therapeutic diets to enhance the immune status in patients with acute pancreatitis are not well established. KEYWORDS: Acute pancreatitis, Enteral nutrition, Parenteral nutrition, Immunonutrition.
MicroRNAs (miRNAs) are short, single-stranded non-coding RNAs that control gene expression by annealing to complementary sequences in mRNAs. They are estimated to regulate at least one third of human transcripts and hence, manipulation of these miRNAs can profoundly affect the proteome and ultimately cellular phenotypes. A substantial amount of work has shed light on the crucial roles of miRNAs in diseases. miRNA expression profiles between normal and diseased tissues have identified miRNA signature patterns that correlate to disease development and progression. This review discusses some of the important miRNAs that are involved in endothelial cell senescence and dysfunction that contribute to the development and progression of cardiovascular diseases.
Objectives: The objectives of our study were to determine the mean age of onset of thelarche and menarche,
to determine the ages of each stage of puberty and to investigate if there are any ethnic differences in these
ages amongst female adolescents in Kuala Lumpur, Malaysia.
Methods: This was a cross-sectional study involving three secondary schools in Cheras, Kuala Lumpur. A total of
730 students were recruited via stratified random sampling. Self-administered survey forms on menstruation
and puberty were used.
Results: Out of 730 recruited respondents, 385 (52.74%) completed the survey and informed consents were
obtained from their parents/legal guardians. Our respondents’ ages ranged between 13 to 17 years old with
the median (IQR) age of 14.00(2.00) years. With regards to ethnicity, 329 (85.50%) were Malay, 46 (11.90%)
were Chinese, 9 (2.30%) were Indian and 1(0.30%) was a Bajau. The mean age for breast development
(thelarche) and menarche were 11.72 ±1.10 and 11.97±1.11 years respectively. The majority, 363 (94.30%),
out of 385 respondents had attained menarche. There appeared to be a later onset of puberty amongst
Malays comparatively.
Conclusion: The mean ages of pubertal onset and menarche amongst female adolescents in the Cheras area
are similar to those reported worldwide.
A cross-sectional survey of commercial vehicle drivers who were renewing their own licences was conducted at the Selangor Road Transport Department office in Padang Jawa between 1 February 2002 and 28 February 2002, using questionnaire and medical examination. The objective was to determine the prevalence of myopia, colour vision deficiency and visual field defect among the commercial vehicle drivers. The respondents that reported visual defect at the time of interview was compared with those detected by the author through medical examination. Out of the 223 respondents, 21 (9.4%) reported to have myopia by the questionnaire survey. Through the visual examination there were 63 (28.3%) with myopia (visual acuity worse than 6/12),six (2.6%) had a visual field defect and 14 (6.3%) had red-green colour deficiency. The visual defect detected during the study among the commercial vehicle drivers, which were missed at the time of the routine medical examination were significant. The process of the statutory medical examination should be reviewed.
Introduction: Cyberbullying is a growing public health menace although research into the topic is very much lacking in Malaysia. This study aimed to determine the prevalence of cyberbullying among Malaysian adolescents and its association to gender, internet use pattern and offline bullying.
Methods: This study adopts a cross-sectional methodology among Malaysian adolescents’ (N=882, 13 to 14 years old) through both the dimensions of victimization and perpetration using the European Cyberbullying Intervention Project Questionnaire (ECIPQ).
Results: The result shows that if the period of the cyberbullying experience is confined to the past one month, the prevalence cyber-victimization and cyber-perpetration are 31.6% and 20.9% respectively. The prevalence however increased by more than 2-fold when it was extended to the past 3-months experience (73.7% and 64.2% respectively). Online harassment seems to dominate the prevalence of various types of cyberbullying in both cyber-victimization and cyber-perpetration dimensions (60.4% and 55.4% respectively). Both offline victims (AOR 2.40, p
Background: In Malaysia, the prevalence of adolescents’ suicidal ideation has increased over the years. Therefore, it is crucial to investigate the predictors of suicidal ideation among adolescents. Hence, the aim of this study was to examine the predicting effects of depression and self-esteem on suicidal ideation among Malaysian adolescents. In addition, the relationships between depression, self-esteem, and adolescents’ suicidal ideation were explored as well.
Methods: By using a multistage cluster sampling method, a cross-sectional study was conducted in secondary schools in Kuala Lumpur, Malaysia. The participants were comprised of 852 adolescents (51% males and 49% females) aged 13-17 years old who completed self-administered questionnaires. Pearson’s Correlation analysis was used to analyse the relationships among depression, self-esteem, and adolescents’ suicidal ideation, while Standard Multiple Regression analysis was used to examine the predicting effects of depression and self-esteem on adolescents’ suicidal ideation.
Results: Depression had a positive correlation with adolescents’ suicidal ideation (r = .290, p < .001), while self-esteem had a negative correlation with adolescents’ suicidal ideation (r = -.283, p < .001). Results also showed that both depression (β = .200, p < .001) and self-esteem (β = -.186, p < .001) significantly predicted adolescents’ suicidal ideation.
Conclusion: The study found that depression is a risk factor, while self-esteem is a protective factor of adolescents’ suicidal ideation.
We investigated the association between polycystic ovarian syndrome, dyslipidemia and glucose intolerance in a cross sectional analysis comparing 50 patients with polycystic ovary syndrome and 50 patients without the disease (control group) who were attending the Infertility clinic. Variables of interest were their body-mass index (Kg/m2), fasting and blood glucose levels after a 75 gram oral glucose tolerance test and their total cholesterol (mmol/L), total triglycerides (mmol/L), high density cholesterol lipoprotein (HDL) cholesterol (mmol/L) and, low density lipoprotein cholesterol (mmol/L) levels. Except for HDL where significantly lower values were observed, significantly higher levels were detected in patients with PCOS than that of the control group. The difference persisted even when the obesity index were adjusted and matched. We conclude that both glucose intolerance and dyslipidemia were significantly associated with PCOS irrespective of the obesity index.
The crux of the current health problem is the alarming increase of dengue cases in the country. Dengue fever is endemic in Southeast Asia with Malaysia seeing dengue cases surge since 2003. The Health Minister of Malaysia has reported that the acute increase in dengue cases is worrying and could hit the country's productivity, tourism industry and economy.(Copied from article).
Little is known of Malaysian older people’s participation in physical activities, and the purpose of this pilot study is to explore their participation and the barriers. A self-administered questionnaire was given to 80 eligible respondents at the Kuala Lumpur Health Clinic of which 70 responded. Thirty-six (51.4%) were males and 34 (48.6%) were females. There were 26 (37.1%) Malays, 20 (28.6%) Chinese, 18 (25.7%) Indians and 6 (8.6%) of other ethnic groups. Forty (57.1%) took part in some form of physical activities and the remaining 30 (42.9%) reported no participation at all. The Chinese participated actively in physical activities (90%), followed by Indians (66.7%) and Malays (30.8%). The five common activities were walking (60%), tai chi (20%), gardening (12.5%), stretching (2.5%) and cycling (5.0%). Identified barriers to physical activities were lack of time (26.7%), having health problems (26.7%), was already fit (26.7%), no companion to exercise with (13.3%) and no exercise knowledge (6.7%). These findings indicated that emphasis should be given to the females and the Malay ethnic group when planning physical activity education for the older people as they were identified to be the least active groups.
Study site: Klinik Kesihatan Kuala Lumpur, Wilayah Persekutuan, Malaysia
The use of brain slice preparatiotis has become ilicreasiligly popular among scientists of different disciplines in recent decades for the study of the mammalian central nervous system (CNS) in general and of synaptic phenomena in particular. The in vitro hippocampal slice may be the single most used preparation, among other slices of different parts of the brain areas. The use of brain slices in different experimental work offers certain advantages over the in vivo approaches to the study of the CNS; however, such preparations may have some limitations. This review describes the hippocampal slice technique, explores some of the different types of studies in which it was employed and points out the advantages and limitations of its use. KEYWORDS: Hippocalnpal slices, brain slices, technique, synaptic function, electrophysiology, in vitvo.
Background: This paper examined the importance and influence of post-transplantation follow-up visits on the quality-of-life (QoL) of living kidney donors in Malaysia.
Methods: Based on data collected from 80 living kidney donors, the relationship between QoL and the frequency of follow-up visits was examined. QoL was measured using standard SF-8 questions to capture its different dimensions.
Results: Donors in the 1991–1998 donation cohort have low QoL, especially in the domains of physical and vitality, compared with the other two cohorts (1999–2005 and 2006–2012). The mean scores showed that donors who never went for any follow-up activities visits experience low QoL in most of the categories, particularly those related to physical activities, implying the importance of follow-up activities visits in influencing the donors’ QoL. Lower QoL was recorded for respondents that never received post-transplant treatment.
Conclusion: Although this study found no serious post-transplant QoL issues in Malaysia, it is still important to set up a donor registry and provide free and mandatory follow-up visits for all donors in order to adequately monitor their health.