MyMedR

Fulltext Haemophagocytic syndrome presenting as pyrexia of unknown origin

Fadilah SA, Raymond AA, Leong CF, Cheong SK

Med J Malaysia, 2006 Mar;61(1):91-3.

Haemophagocytic syndrome (HPS) should be included in the differential diagnosis of pyrexia of unknown origin (PUO). The hallmark of HPS is the accumulation of activated macrophages that engulf haematopoietic cells in the reticuloendothelial system. We describe a patient with unexplained fever in which a final diagnosis of HPS was established in a bone marrow study.

Matched MeSH terms: Female

Fulltext Mucinous adenocarcinoma of the rectum with breast and ocular metastases

Hisham RB, Thuaibah H, Gul YA

Asian J Surg, 2006 Apr;29(2):95-7.

PMID: 16644510

We present the case of a 32-year-old woman who, 10 months after abdominoperineal resection and total mesorectal excision for a locally advanced mucinous adenocarcinoma of the rectum, presented with local recurrence and metastases to the breast, spine, the left eye and orbit. Following surgery, due to the patient's personal reasons, adjuvant chemoradiation was not given. The patient died 2 months later, with disseminated cancer. To the best of our knowledge, breast as well as ocular metastasis in a patient with mucinous adenocarcinoma of the rectum has never been reported and, therefore, needs to be documented.

Matched MeSH terms: Female

A new species of Aberrapex Jensen, 2001 (Cestoda: Lecanicephalidea) from Taeniura lymma (Forsskål) (Myliobatiformes: Dasyatidae) from off Sabah, Malaysia

Jensen K

Syst Parasitol, 2006 Jun;64(2):117-23.

PMID: 16612652

A new lecanicephalidean species of Aberrapex Jensen, 2001 is described from the blue-spotted fantail ray Taeniura lymma (Forsskål) collected off the eastern coast of Sabah in Malaysian Borneo. This is the first record of a lecanicephalidean tapeworm from the island of Borneo and the first record of Aberrapex from this host species. A. manjajiae n. sp. is easily distinguished from its two congeners, A. senticosus Jensen, 2001 and A. arrhynchum (Brooks, Mayes & Thorson, 1981) Jensen, 2001, based on its overall smaller size (928-1,971 vs 1,485-6,333 and up to 3,350 microm long, respectively) and fewer testes (10-19 vs 20-40 and 18-25, respectively). In addition, A. manjajiae n. sp. is readily distinguished from A. senticosus based on a more anteriorly positioned genital pore (76-85 vs 52-72% of proglottid length from posterior end) and its distal bothridial microthrix pattern. A. manjajiae n. sp. can be further distinguished from A. arrhynchum based on its smaller scolex (82-101 x 119-164 vs 177-186 x 233-326 microm). The host distribution of Aberrapex is expanded from the Myliobatidae to include the Dasyatidae.

Matched MeSH terms: Female

Fulltext Successful pregnancy in untreated limited Wegener's granulomatosis

Sahni V, Agarwal SK, Singh NP, Sikdar S, Yadav A, Wadhwa A, et al.

Med J Malaysia, 2005 Oct;60(4):492-4.

PMID: 16570714

A thirty four year old female presented with upper and lower respiratory symptoms in the third trimester of pregnancy. After the delivery of a healthy baby, the symptoms progressed to involve multiple organ systems and eventually a diagnosis of limited Wegener's Granulomatosis (Carrington-Liebow syndrome) was made. The extremely rare combination of WG and pregnancy, especially the onset of disease in late pregnancy is discussed. The successful outcome of pregnancy even without treatment of WG is the highlight of the case.

Matched MeSH terms: Female

Fulltext Accelerated diabetic retinopathy in pregnancy--a real and present danger

Bastion MLC, Barkeh HJ, Muhaya M

Med J Malaysia, 2005 Oct;60(4):502-4.

PMID: 16570717

A 36 year-old Malay lady with diabetes mellitus in pregnancy and poorly controlled hypertension developed rapid progression of diabetic retinopathy from no retinopathy to florid proliferative retinopathy over three months in her right eye. She had subsequent loss of vision due to vitreous haemorrhage in the peri-partum period. She had good final visual acuity with quiescent retinopathy following pars planar vitrectomy. A similar course was avoided in the left eye by timely pan retinal photocoagulation.

Matched MeSH terms: Female

Fulltext Melioidosis: the Johor Bahru experience

Pagalavan L

Med J Malaysia, 2005 Dec;60(5):599-605.

PMID: 16515111

A 5 year retrospective review of cases of melioidosis was carried out in Sultanah Aminah Hospital, Johor Bahru. There were 44 new cases of melioidosis which was proven by either blood or pus culture growing Burkholderia pseudomallei from the period between January 1999 and December 2003. Of these, 38 (86.4%) were males compared to only 6 (13.6%) females. Thirty-one (70.5%) were Malays, 7 (15.9%) were Chinese, 5 (11.4%) were Indians and 1 (2.2%) was a Sarawakian. The peak age group was between 50 and 59 years (31.8%). Out of these 44 new cases, only 32 medical records could be retrieved and analysed. Twenty-four out of 32 patients (75%) analysed had diabetes mellitus, 4 had chronic or end stage renal failure (CRF/ESRF) and only 1 had Human Immunodeficiency Virus (HIV). One case of "near drowning" was also recorded. Twenty-one out of 44 patients or 47.7% died, of which 8 (38.1%) died within 24 hours of admission. Pulmonary involvement was recorded in 62.6% of the patients but many had signs and symptoms of multiorgan involvement.

Matched MeSH terms: Female

Fulltext The profile of lymphadenopathy in adults and children

Darnal HK, Karim N, Kamini K, Angela K

Med J Malaysia, 2005 Dec;60(5):590-8.

PMID: 16515110

Surgical biopsies of lymphnodes of 315 patients (273 adult and 42 children) were reviewed microscopically and analysed. The sex ratio was similar in adults but in children males were twice than female (2:1). Ethnically Malay patients predominated in both the groups. The commonest cause of biopsied lymphadenopathy in adults were malignancy (47%) followed by chronic nonspecific lymphadenitis (20%) and granulomatous lymphadenitis (9%) while in children chronic nonspecific lymphadenitis was the commonest (46%) followed by granulomatous lymphadentitis (21%) and malignancy (14%). Twenty percent of adults and 4% of children had normal lymphnodes. Secondary deposits in adult males and females were of squamous cell carcinoma and adenocarcinoma type respectively. In our study 100% of clildren and 96% of adults with granulomatous lymphadenitis had tubercular lesions.

Matched MeSH terms: Female

Fulltext Workplace vaccination against influenza in Malaysia: does the employer benefit?

Samad AH, Usul MH, Zakaria D, Ismail R, Tasset-Tisseau A, Baron-Papillon F, et al.

J Occup Health, 2006 Jan;48(1):1-10.

PMID: 16484757

This study was designed to evaluate the health and economic benefits of a workplace vaccination programme against influenza funded by the employer. Employees of a Malaysian petrochemical plant volunteered to take part in this prospective, non-randomised, non-placebo-controlled study. Demographic and health information, including influenza-like symptoms, sick leave and post-vaccination adverse events were collected via questionnaires. Cost-benefit analyses were performed from the employer's perspective.

RESULTS: A total of 1,022 employees took part in the study, with 504 choosing to be vaccinated against influenza, and 518 remaining unvaccinated. The rate of influenza-like illness (ILI) was lower among vaccinated (8.13%) than non-vaccinated subjects (30.31%). Fever and respiratory symptoms were associated with all ILI cases. ILI-related sick leave was taken by 58.54% of vaccinated employees with ILI and 71.34% of non-vaccinated employees with ILI. Vaccination was financially beneficial, with the employer saving up to US dollar 53.00 per vaccinated employee when labour costs only were considered. Savings rose to up to US dollar 899.70 when the operating income of each employee was also considered. Workplace vaccination of healthy adults against influenza had a clear impact on ILI rates, absenteeism and reduced productivity in this Malaysian company. The health benefits translated into financial benefits for the employer, with cost savings significantly outweighting the costs of the vaccination programme.

Matched MeSH terms: Female

Fulltext Clinical features of acute febrile thrombocytopaenia among patients attending primary care clinics

Tong SF, Abd Aziz NA, Chin GL, Khairani O

Malays Fam Physician, 2006;1(1):15-8.

PMID: 26998201 MyJurnal

Identifying clinical features that differentiate acute febrile thrombocytopaenia from acute febrile illness without thrombocytopaenia can help primary care physician to decide whether to order a full blood count (FBC). This is important because thrombocytopaenia in viral fever may signify more serious underlying aetiology like dengue infection.

Matched MeSH terms: Female

Fulltext Beauty Or Health? A Personal View

Riji HM

Malays Fam Physician, 2006;1(1):42-4.

PMID: 26998213 MyJurnal

This paper deals with the question of beauty and health in women. It discusses changing definitions of beauty as a result of influences from the entertainment, beauty and health product industries. Advertisements are seen to be major players in defining beauty through promotion of cosmetic, skin, hair and slimming products. Concerns relating to beauty become inculcated in girls through the process of socialisation as they mature into womanhood. The media plays a significant role in portraying the meaning of beauty through its representation of women. These influences largely influence and alter women's perceptions of their body image and in trying to meet the goals of beauty as represented by the media. This may result in dissatisfaction with their body image. Advertisements can encourage women to indulge in smoking as a fashionable trend or opt for plastic surgery in attempts to acquire beauty. This paper concludes with implications of the issues relating to changing perceptions of beauty and suggests recommendations.

Matched MeSH terms: Female

Fulltext Modular endoprosthetic replacement after total femur resection for malignant bone tumor

Faisham WI, Zulmi W, Halim AS

Med J Malaysia, 2005 Jul;60 Suppl C:45-8.

PMID: 16381283

Total femur endoprothesis is an alternative replacement for massive malignant bone tumor with intramedullary extension or skip lesion. Four patients underwent total femoral resection and replacement with megaprosthesis: three had primary malignant bone tumor and one had salvage procedure for aseptic loosening of the distal femoral replacement. Tumor-free margins were achieved in all patients with two patients required vascularized latissimus dorsi free flap cover for reconstruction of soft tissue defects. The average follow-up was 24 months (range 16 - 60 months). All four patients were still alive with three of them being disease-free and one survived even with the presence of lung metastasis. The functional results obtained were either excellent or good in all patients in accordance to the Musculoskeletal Tumors Society grading system.

Matched MeSH terms: Female

Fulltext Measurement of patellar thickness in relation to patellar resurfacing

Sulaiman AS, Nordin S

Med J Malaysia, 2005 Jul;60 Suppl C:41-4.

PMID: 16381282

Patellar thickness is an important consideration for resurfacing in total knee arthroplasty. A patella of 25 mm in thickness is not suitable for resurfacing using the currently available total knee systems. A cross sectional study on patellar thickness using plain radiographs was undertaken on 56 patients. It was observed that the average thickness of the bony part of the patella was 20.05 mm (range 17-23 mm). The actual thickness of cartilage varies from 2.0 to 5.5 mm (mean 3.2 mm). Thus the mean thickness of the patella was 23.2 mm (range 20.2-26.2 mm). The majority of our patients (73%) had patellar thickness of 24 mm or less. The patellar thickness had a significant correlation with the patient's height (R=0.5). Since the majority of our patients have thin patella, we are of the opinion that majority of our patients are not suitable for patellar resurfacing.

Matched MeSH terms: Female

Fulltext Shoulder arthrodesis in brachial plexus injuries--a review of six cases

Wong ELW, Kwan MK, Loh WYC, Ahmad TS

Med J Malaysia, 2005 Jul;60 Suppl C:72-7.

PMID: 16381288

Shoulder arthrodesis is a secondary reconstructive option for patients with brachial plexus injuries requiring a stable shoulder. This study was undertaken to evaluate the clinical and radiological outcomes of shoulder fusion in six patients with flail upper limbs following complete brachial plexus injuries. The shoulder was fused in 30 degrees abduction, 30 degrees internal rotation and 30 degrees flexion via a direct lateral approach by using a 4.5 mm reconstruction plate without bone grafting. The average follow-up was 10.3 months. Radiological union was obtained in all patients. Five patients (83%) had relief of pain after the shoulder fusion. Improvement of function was observed in all patients with a mean improvement of 56.6 degrees (range 30 degrees-75 degrees) and 47.5 degrees (range 30 degrees-60 degrees) active flexion and abduction respectively. One patient developed humeral fracture distal to the plate and the fracture eventually healed with a splint. Successful stable fusion of the shoulder in patients with brachial plexus injuries requires rigid fixation with a single 4.5 mm reconstruction plate, protection of bone healing with a triangular abduction brace for 12 weeks and functional trapezius, levator scapulae, serratus anterior and rhomboid muscles for optimizing the functional result.

Matched MeSH terms: Female

Fulltext Reconstruction of the heel defect with in-step island flap. A report of four cases

Kwan MK, Marican AM, Ahmad TS

Med J Malaysia, 2005 Jul;60 Suppl C:104-7.

PMID: 16381293

Soft tissue loss of the heel is difficult to treat as it may cause significant morbidity particularly recurrent ulceration and subsequent chronic osteomyelitis. Reconstruction of such defect with local flap can provide good result. We report our experience in treating four patients with heel defect using the in-step island flap. The flap, which is based on the medial plantar neurovascular pedicle, provides a sensate durable tissue required for weight-bearing and normal gait.

Matched MeSH terms: Female

Three new species of Leptolalax from Thailand (Amphibia, Anura, Megophryidae)

Matsui M

Zoolog Sci, 2006 Sep;23(9):821-30.

PMID: 17043405

Three new megophryid species, Leptolalax melanoleucus, L. fuliginosus, and L. solus, are described from southwestern and southern Thailand on the bases of acoustic and morphological characteristics. Leptolalax melanoleucus and L. fuliginosus are similar to L. pelodytoides from northern Thailand, but differ from it completely in advertisement call characteristics and ventral color. Leptolalax solus is similar to L. heteropus from peninsular Malaysia, but differs from it by advertisement call, as well as by some body proportions. The distributional pattern of Leptolalax within Thailand is discussed.

Matched MeSH terms: Female

Hand grip strength in the adult Malaysian population

Kamarul T, Ahmad TS, Loh WY

J Orthop Surg (Hong Kong), 2006 Aug;14(2):172-7.

PMID: 16914783

To measure the hand grip strength of Malaysians aged 18 to 65 years.

Matched MeSH terms: Female

Vessel density ratio: A novel approach to identify "culprit" coronary lesion by spiral computed tomography

Chin BS, Ong TK, Seyfarth TM, Liew CK, Chan WL, Rapaee A, et al.

J Comput Assist Tomogr, 2006 7 18;30(4):564-8.

PMID: 16845284

BACKGROUND AND OBJECTIVE: We hypothesized that a "culprit" lesion in acute coronary syndrome (ACS) should have low overall vessel lumen and plaque density on multidetector computed tomography-assisted coronary angiography (MDCTA) because of lower calcification and the presence of occlusive thrombus. However, thrombi and calcification both can themselves blur the demarcation between vessel wall and lumen. If we calculated a "vessel density ratio" (VDR) obtained by measuring the mean density of contrast-enhancement within a region of interest (ROI), which includes the vessel wall, lumen, plaque, and thrombus, and comparing that with the aortic root mean density acting as a reference point, this ratio may be more convenient, standardized, and reproducible to test the feasibility of VDR in identifying "culprit" lesions in ACS.

METHODS: Sixty-four patients-21 exertional angina; 17 unstable angina/non-ST elevation myocardial infarction (NSTEMI); 26 ST elevation myocardial infarction (STEMI)-provided 188 diseased segments on conventional angiography. All underwent MDCTA within a week of angiography. ROI was mapped out from maximum intensity projections of diseased segments in planar view.

RESULTS: One hundred seventy-four segments were evaluated. Patients who presented with ACS (STEMI and unstable angina/non-ST elevation myocardial infarction) had lower mean VDR compared to patients with exertional angina (0.58 vs. 0.66 vs. 0.81; P < 0.001). Culprit lesions in ACS patients also had the lowest mean VDR when compared to nonculprit lesions and lesions in patients without ACS (0.51 vs. 0.68 vs. 0.81; P < 0.001).

CONCLUSIONS: VDR is a new, convenient, and standardized approach in identifying "culprit" lesions by MDCTA.

Matched MeSH terms: Female

Philopatry and reproductive success in Bornean orang-utans (Pongo pygmaeus)

Goossens B, Setchell JM, James SS, Funk SM, Chikhi L, Abulani A, et al.

Mol Ecol, 2006 Aug;15(9):2577-88.

PMID: 16842428

Behavioural observations suggest that orang-utans are semi-solitary animals with females being philopatric and males roaming more widely in search of receptive partners, leading to the prediction that females are more closely related than males at any given site. In contrast, our study presents evidence for male and female philopatry in the orang-utan. We examined patterns of relatedness and parentage in a wild orang-utan population in Borneo using noninvasively collected DNA samples from animals observed to defecate, and microsatellite markers to assess dispersal and mating strategies. Surprisingly, resident females were equally as related to other resident females (mean r(xy) = 0.303) as resident males were to other resident males (mean r(xy) = 0.305). Moreover, resident females were more related to each other and to the resident males than they were to nonresident females, and resident males were more related to each other (and resident females) than they were to nonresident males. We assigned genetic mothers to 12 individuals in the population, while sires could be identified for eight. Both flanged males and unflanged males achieved paternity, similar to findings reported for Sumatran orang-utans.

Matched MeSH terms: Female

Fulltext Use of combined contralateral deltopectoral skin flap and ipsilateral island latissimus dorsi myocutaneous flap for massive cervico-thoracic oesophagus defect repair

Yap CM

Med J Malaysia, 2005 Aug;60(3):364-6.

PMID: 16379194

Restoring the intestinal continuity of an acquired massive cervico-thoracic oesophagus defect is a reconstructive challenge. A case requiring such defect restoration following a failed pedicled colonic interposition bypass graft between the cervical oesophagus and stomach for an intra-thoracic oesophageal perforation is presented. The defect between the oesophagostome at the lower left neck and the stoma of the colonic stump at the lower left chest measured about 20 cm. An ante-thoracic skin-tube neo-esophagus was constructed in two stages using a pedicled contralateral right deltopectoral skin flap and a pedicled ipsilateral island left latissimus dorsi myocutaneous flap (LD MC flap). A normal swallowing mechanism was re-established.

Matched MeSH terms: Female

Educational performance of pediatric cochlear implant recipients in mainstream classes

Mukari SZ, Ling LN, Ghani HA

Int J Pediatr Otorhinolaryngol, 2007 Feb;71(2):231-40.

PMID: 17109974

The present study documents the school performance of 20 pediatric cochlear implant recipients who attended mainstream classes and compares their educational performance with their normally hearing peers.

Matched MeSH terms: Female

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