MyMedR

A 5-year clinicopathological study on microscopic colitis at a Malaysian tertiary hospital

Abdul Hafidz MI, Zulkifli KK, Win TT, Mat Zin AA, Mustaffa N

Med J Malaysia, 2021 05;76(3):318-325.

INTRODUCTION: Microscopic colitis (MC) is a well-recognised cause of chronic diarrhoea in Western countries. It is classically associated with normal endoscopic findings and a higher prevalence among patients with autoimmune disease. Local information regarding this disease remains scarce. We identified patients diagnosed with MC over a five-year period, and then proceeded to analyse the clinical characteristics of these cases.

MATERIALS AND METHODS: A retrospective study was conducted by identifying all histologically confirmed colitis cases diagnosed at Hospital Universiti Sains Malaysia from January 2015 until December 2019. Clinicodemographic data was retrieved from case notes of patients.

RESULTS: Of the 299 cases with histological colitis, 23 (7.7%) were initially identified as MC. Two cases had incomplete data, while two others were excluded as the diagnoses were revised to inflammatory bowel disease. An incidence of 14 MC cases/1000 case-year was obtained using the 21 MC cases seen within the five-year period. MC subtypes for the 19 analysed cases i.e., lymphocytic colitis and collagenous colitis accounted for 13 (68.4%) and 6 (31.6%) cases, respectively. Eleven patients (57.9%) were females (M:F ratio 1:1.5) with a median age of 51 years. Only nine (47.3%) presented with diarrhoea; one subject (5.4%) had an autoimmune condition (Hashimoto thyroiditis). Normal endoscopic findings were found in 89.5% of patients.

CONCLUSION: Approximately half of the subjects in our study who had histologically confirmed MC did not present with diarrhoea. Adequate biopsy samples despite normal colonoscopy findings are important in order to not miss the diagnosis of MC.

Fulltext A child with septic arthritis of hip: a rarely encountered cause

Abdul Halim AR, Norhamdan Y, Ramliza R

Med J Malaysia, 2011 Jun;66(2):154-5.

PMID: 22106702 MyJurnal

We report a rare case of septic arthritis in a healthy child caused by Salmonella enteritidis. No predisposing factor was detected. Salmonella enteritidis was isolated from the infected joint tissue obtained following surgical drainage. Based on the culture and sensitivity report, he was treated with a 6-week course of antibiotic. He improved dramatically without any detrimental sequelae at end of one year.

Fulltext Correction of claw fingers in leprosy by the brand four-tailed tendon graft operation

Abdul Hamid AK

Med J Malaysia, 1986 Sep;41(3):264-8.

PMID: 3670144

Many operations have been described for the correction of claw hands following involvement in leprosy, from Sir Harold Stiles (1922) of Edinburgh, through Bunnell, Brand and many others in India and USA. Some of these procedures are classified "static" and attempt mainly to correct hyper-extension at the metacarpo-phalangeal joint, while the "dynamic" procedures employ a variety of tendon graft operations to restore the function of the paralysed lumbrical muscles. This study is an analysis of the four-tailed tendon graft operation of Paul Brand, carried out in the National Leprosy Con. trol Centre, Sungei Buloh, Selangor, during the period 1965·175, by a host of surgeons, mainly by Dr M.K. Bhojwani, MRCP, FRCSEd, the Director of the Centre at that time. The analysis carried out during November. December 1976, was made on 36 hands in 33 patients; it revealed an average improvement in the metacarpo. Phalangeal joint flexion of nearly 90% and in the proximal interphalangeal joint extension in nearly 80%, and an improvement in the grafted lumbrical voluntary motor tone of nearly 70%.

Fulltext How much should doctors tell their patients?

Abdul Hamid AK

Med J Malaysia, 2002 Jun;57(2):133-5.

PMID: 24326642

Private medical education--the doctor's perspective

Abdul Hamid AK

Med J Malaysia, 2000 Aug;55 Suppl B:23-7.

PMID: 11125516

The Government's decision to drastically and speedily increase the number of doctors in the country needs to be reviewed. The standard and quality of health care does not depend on the number of doctors, but on the improvement of the health care infrastructure. Increasing the number of government medical schools and increasing the intake of students should be done on a need-to basis, with the above perspective in mind. The selection criteria of candidates must not be compromised and the teaching staff must be adequate and experienced. The number of doctors should be gradually increased over the years in tandem with the development of the health care infrastructure and the deployment of doctors must be directed at providing equitable care to the people at all economic levels and geographic locations. The strength of academic staff in existing government medical schools must be upgraded to provide high level of teaching and research, perhaps reinforced with the recruitment of suitably qualified and experienced foreign teachers. The infrastructure of existing government medical schools must be upgraded to cater for the gradual increasing demand for more doctors as the country develops. The selection of candidates for the government medical schools must be based on merit and without undue emphasis on ethnic considerations, for it is only in the arena of fair competitiveness that excellence can be born. The considerations of merit in selection must include assessment of attitude, self-development, moral ethics and reasoning. If the above perspectives are fully appreciated, then there is really no requirement for private medical colleges in Malaysia.

Fulltext Patient registries supplement. Foreword

Abdul Hamid M

Med J Malaysia, 2008 Sep;63 Suppl C:vii.

PMID: 19227668

Strengthening acute coronary syndrome referral network: Insights from initiatives of Penang General Hospital cardiology centre

Abdul Kader MAS

Med J Malaysia, 2019 08;74(4):355-358.

PMID: 31424052

The importance of networking for the management of acute coronary syndrome (ACS) has been emphasised in the 2012 guidelines by the European Society of Cardiology (ESC) on ST-segment elevation myocardial infarction (STEMI). In Penang, the ACS referral network has the Penang General Hospital (PGH), a percutaneous coronary intervention (PCI)- capable hospital, with 14 other hospitals referring their patients for PCI to PGH on a daily basis. In one of its review regarding the referral methodology in the network, PGH's Cardiology centre observed gaps in the referral systems, which was leading to poor quality of referrals. To address these issues, the PGH Cardiology centre developed a standardised protocol and conducted a one-day workshop to educate medical officers about the standardised protocol. This commentary piece is a proof of this concept, and aims to share the experience and provide an overview on the initiatives by the PGH, which has resulted in improved quality of PCI referrals.

Fulltext For one crowded hour of glorious life

Abdul Kadir AH

Med J Malaysia, 1986 Sep;41(3):186-8.

PMID: 3670134

Fulltext Major lower limb amputations

Abdul Kadir AH, Myint Han

Med J Malaysia, 1988 Sep;43(3):218-23.

PMID: 3241579

Fertility preservation opportunities for cancer patients in Malaysia

Abdul Karim AK, Ahmad MF, Abdul Hamid H

Med J Malaysia, 2021 05;76(3):417-418.

PMID: 34031343

Fertility preservation is significant for oncology patients to maintain their ability to start a family when they are ready. Onco-fertility, as a discipline, exists at the intersection of oncology and reproductive medicine that safeguards and expands the fertility options for cancer survivors, by facilitating early intervention and suitable treatment with favourable outcomes. Successful fertility preservation requires a comprehensive networking among the gynaecologists, oncologists, pathologists, imaging and other specialists, involved in diagnosing and treating cancer in the reproductive age group. There are several ways in which fertility can be preserved, like role of gonadotrophin releasing hormone analogues, in vitro maturation, and cryopreservation.

Fulltext Optic disc topography of normal tension glaucoma patients in Malaysia

Abdul Rahim A, Ismail S, Ahmad Tajudin LS, Ahmad MS

Med J Malaysia, 2013 Aug;68(4):338-42.

PMID: 24145263 MyJurnal

There are limited data in the literature on the optic disc topography in normal tension glaucoma (NTG) patients in Asian countries, especially in Southeast Asia. This study is aimed at comparing optic disc topography in NTG patients and a control group in Malaysia, and we discuss the literature on NTG studies in other Asian populations. A comparative cross-sectional study was conducted in two hospitals with glaucoma services in Malaysia from November 2010 to February 2012. A total of 109 eyes of 109 Malay patients were included in this study: 32 NTG patients and 77 subjects in the control group. All participants underwent a thorough ocular examination, including visual acuity, subjective refraction, anterior segment and fundus examinations, Humphrey visual field 24-2, intraocular pressure measurement, gonioscopy examination and fundus photography. Optic disc topography was assessed using the Heidelberg Retinal Tomograph III by an identified masked investigator in each hospital. NTG patients had a notably larger disc area (2.65 (0.41) vs 2.19 (0.43) mm(2), respectively), larger cupping (1.54 (0.43) vs 0.63 (0.40) mm(2), respectively), smaller retinal rim areas (1.12 (0.41) vs 1.56 (0.33) mm(2), respectively), higher cup volume (0.47 (0.28) vs 0.11 (0.19) mm(3), respectively), reduced rim volume (0.23 (0.13) vs 0.41 (0.16) mm(3), respectively), higher cup to disc area ratio (0.58 (0.14) vs 0.27 (0.15), respectively), higher linear cup to disc ratio (0.76 (0.09) vs 0.49 (0.17) mm(2), respectively), higher mean cup depth (0.37 (0.09) vs 0.22 (0.09) mm, respectively), higher maximum cup depth (0.77 (0.16) vs 0.59 (0.20) mm, respectively), higher mean of cup shape measure (-0.04 (0.06) vs -0.16 (0.07), respectively), and thinner mean retinal nerve fibre layer thickness (0.15 (0.15) vs 0.24 (0.07) mm, respectively) compared to the control group (p<0.05). In conclusion, most of the optic disc parameters were significantly different in NTG patients compared to healthy individuals in Malaysia. Our findings are comparable to those reported in NTG studies in other Asian countries.

Apoptosis changes and SA-beta galactosidase expression in stress-induced premature senescence (SIPS) model of human skin fibroblasts

Abdul Rahim N, Makpol S, Chua KH, Yusof YA, Top GM, Ngah WZ

Med J Malaysia, 2008 Jul;63 Suppl A:71-2.

PMID: 19024989

Stress-induced premature senescence (SIPS) model is in vitro model of cellular aging. In this study, apoptosis was evaluated in SIPS model and in replicative senescent fibroblasts. We also compared the activity of senescence-associated beta-galactosidase (SA-beta gal) as a biomarker of cellular aging. Our results suggested that SIPS model and senescent fibroblasts might share similar mechanism of aging and apoptosis pathway.

Fulltext Female sterilization with Hulka clips--initial experience at the University Hospital, Kuala Lumpur

Abdul Rahman A, Sivanesaratnam V, Nuruddin AA

Med J Malaysia, 1982 Sep;37(3):276-80.

PMID: 7177012

An analysis of 86 patients sterilized laparoscopically with Hulka clips is presented. We find that the method is simple, acceptable and has minimal complication. The failure rate is similar to that reported by others. However, this method could be done under local anaesthesia thus shortening the hospital stay for the patients. This method has the advantage of safety and prospects for reversal when desired.

Fulltext Laparoscopic sterilization with fallope rings - a Malaysian experience

Abdul Rahman A, Sinnathuray TA, Sivanesaratnam V, Ng KH

Med J Malaysia, 1981 Jun;36(2):92-9.

PMID: 6211595

The early Malaysian experience of laparoscopic sterilisation with the Fallope tubal rings, as undertaken at the Obstetrical and Gynaecological Unit of the University Hospital, University of Malaya in Kuala Lumpur, Malaysia is reported in a study of 291 consecutive females that had had the procedure undertaken during the one year period, May 1975 to April 1976. Of the 291 cases, 247 women were sterilised in the "interval" period, 43 after "menstrual regulation" procedure and one after a spontaneous abortion. General anaesthesia was used in all except one case. The salient socio-demographic, contraceptive and reproductive characteristics of study cases are presented and discussed. The technical problems, the early complications and morbidity encountered in this study are presented and discussed in the light of other similar studies, and in relation to sterilisation by laparoscopic tubal electrocoagulation. The overall impression is that laparoscopic sterilisation with the Fallope tubal rings is preferred to that by tubal electrocoagulation, in view of the possible inadvertent serious electrical burns of other structures during the use of the latter procedure.

Upregulation of SOX-2, FZD9, Nestin, OCT-4 and FGF-4 expression in human chorion derived-stem cells after angiogenic induction

Abdul Rahman H, Manzor NF, Tan GC, Tan AE, Chua KH

Med J Malaysia, 2008 Jul;63 Suppl A:57-8.

PMID: 19024982

Angiogenic induction was made to promote angiogenesis by differentiating stem cells towards endothelial cells. However, the stemness property of induced cells has not been revealed yet. Hence, we aim to evaluate the differential mRNA expression of stemness genes in human chorion-derived stem cells (CDSC) after being cultured in EDM50 comprised bFGF and VEGF. Results indicated that CDSC cultured in EMD50 expressed significantly higher mRNA level of Sox-2, FZD9, BST-1 and Nestin. In addition Oct-4, FGF-4 and ABCG-2 were also upregulated. Our finding suggested that CDSC after angiogenic induction enhanced its stem cell properties. This could be contributed for the mechanism of stem cell therapy in ischemic problem.

Polyps! Polyps! And More Polyps! - The First Case of Cronkhite-Canada Syndrome in Malaysia

Abdul Rani R, Hussin FR, Hamzaini AH, Isa MR, Raja Ali RA

Med J Malaysia, 2016 02;71(1):37-8.

PMID: 27130745

Cronkhite-Canada Syndrome (CCS) is a syndrome characterised by a constellation of signs including but not limited to onychodystrophy of the finger and toe nails, skin hyperpigmentation and alopecia. Endoscopic features showed hamartomatous polyps involving all segments of the gastrointestinal tract with the characteristic exception of being oesophageal sparring. These polyps show confirmation by the presence of eosinophils and mast cells at the lamina propria upon histological studies.

Fulltext Suboptimal treatment in chronic diseases--time to go back to basics

Abdul Rashid AR

Med J Malaysia, 2008 Aug;63(3):185-7.

PMID: 19248686

Fulltext Pharmacological evaluation of aqueous root extract of Selayak Hitam: teratogenic and possible abortifacient effect

Abdul Razak D, Gan EK, Mohamad M, Lajis R, Sam TW

Med J Malaysia, 1984 Mar;39(1):48-51.

PMID: 6513840

Studies made on aqueous root extract of Selayak Hitam, a plant alleged to possess abortifacient activity in pregnant mothers established that the extract is teratogenic and did in fact cause abortion in mice. It was also observed that the aqueous root extract is relatively toxic as judged by the number of deaths occuring following administration of the extract. The mechanism by which abortion is brought about is unknown but it is possible that the abortifacient effect is due to the induced teratogenic activity, brought about by the extract.

An in vivo study of a locally-manufactured hydroxyapatite-based material as bone replacement material

Abdul Razak NH, Al-Salihi KA, Samsudin AR

Med J Malaysia, 2004 May;59 Suppl B:119-20.

PMID: 15468847

Defects were created in the mandible of a rabbit model whereby the right side was implanted with hydroxyapatite (HA) while the left side was left empty to act as control. Both the implant and control sites were evaluated clinically and histologically at 4,12,20,22 weeks. Decalcified sections were studied under confocal laser scanning microscope. No reactive cells were evident microscopically in all sections. There was bone ingrowth as early as 4 weeks when viewed by the topographic method. Enhancement of osteoconduction was evident by the presence of abundant capillaries, perivascular tissue and osteoprogenitor cells of the host. At 22 weeks, the implanted defect showed mature bone formation filling almost the whole field. This study demonstrated that the dense HA exhibits excellent biocompatibility as noted by the complete absence of reactive cells. It also promotes osteoconduction.

Fulltext Isolation of Legionella pneumophila from hospital cooling towers in Johor, Malaysia

Abdul Samad BH, Suhaili MR, Baba N, Rajasekaran G

Med J Malaysia, 2004 Aug;59(3):297-304.

PMID: 15727373 MyJurnal

Water-based cooling towers and their water supply at two hospitals in Johor were surveyed for the presence Legionella pneumophila. L. pneumophila were grown from 19 (76%) out of 25 collected water samples. One hospital cooling tower was contaminated with L. pneumophila serogroup 1.

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