MyMedR

Displaying publications 4861 - 4880 of 5664 in total

Abstract:

Sort:

Fulltext The effect of prophylactic phenylephrine on systemic hypotension during induction of anaesthesia with propofol in patients over 55 years old

Kwok FY, Venugobal S

Med J Malaysia, 2016 Aug;71(4):166-170.
PMID: 27770114 MyJurnal

Induction of anaesthesia with propofol is often associated with a significant decrease in arterial pressure, especially in the older population. The aim of this study is to determine the efficacy of phenylephrine in two different doses i.e. 100mcg and 200mcg, given during induction to counteract the anticipated hypotensive effect of propofol in older patients aged over 55 years.
Fulltext Late presentation of ALCAPA syndrome in an elderly Asian lady

Yew KL, Kang Z, Anum A

Med J Malaysia, 2016 Aug;71(4):217-219.
PMID: 27770127 MyJurnal

Coronary artery anomalies are often discovered incidentally during cardiac catheterization or computed tomography coronary angiography and may involve the affected coronary artery origin and its course. Coronary artery anomalies are associated with congenital heart disease. The affected coronary arteries may have an unusual high take off origin, origin from contralateral or non-coronary sinus, origin from the pulmonary artery, single coronary system or coronary artery fistula.
Fulltext Gastrointestinal bleeding caused by epitheloid sarcoma: A case report

Lee FY, Lim L, Gee T

Med J Malaysia, 2016 Aug;71(4):215-216.
PMID: 27770126 MyJurnal

Epithelioid sarcoma (ES) of the small bowel is a rare gastrointestinal tumour. We report a case of gastrointestinal bleeding secondary to small bowel ES in a 55-year-old gentleman. After gastroscopy and colonoscopy failed to identify the source of bleeding, we proceeded with computed tomography angiogram of the mesentery, which revealed intraluminal blood clot in the distal jejunum with features of obstruction. This is a rare cause of obscure gastrointestinal bleeding and emphasises the need for additional evaluation in the presence of negative endoscopic findings.
Fulltext Discrepancy in blood pressure between the left and right arms - importance of clinical diagnosis and role of radiological imaging

Kuan PX, Tan PW, Jobli AT, Abd Razak N

Med J Malaysia, 2016 Aug;71(4):206-208.
PMID: 27770122 MyJurnal

Differences in systolic blood pressure reading between arms are common but could signal trouble if the discrepancy is significant. Early detection of aortic dissection could invariably determine patient's survivability. Hence, a high index of suspicion with prompt diagnostic imaging is vital for accurate diagnosis.
Fulltext A curious case of Meckel's diverticulum

Arvind M, Dharmaraj B, Ibrahim MR, Nijhar JS, Azizi ZA

Med J Malaysia, 2016 Aug;71(4):203-205.
PMID: 27770121

Meckel's diverticulitis or Meckel's associated pathology frequently presents in childhood with gastrointestinal bleeding. It is rarely seen in adults. It is a congenital abnormality that commonly goes undetected. We present a case of a perforated Meckel's diverticulum due to fishbone ingestion in an elderly gentleman. The aim of this case report is to highlight the rare presentation of a perforation in a Meckel's diverticulum due to an extrinsic pathology and to outline diagnostic and management options in cases of Meckel's diverticulum.
A dedifferentiated large posterior mediastinal liposarcoma - An incidental finding successfully resected

Narasimman S, Jasjit SN, Navarasi SR, Premnath N

Med J Malaysia, 2016 08;71(4):201-202.
PMID: 27770120

This is a case of a posterior mediastinal mass in an asymptomatic gentleman, which was resected successfully and he has been disease free for more than a year of follow up. The histopathology findings happen to be a rare occurrence.
Fulltext You can never have too many accessories - a case of two accessory muscles of the ankle

See PP

Med J Malaysia, 2016 Aug;71(4):199-200.
PMID: 27770119

Accessory muscles are relatively rare anatomic duplications of muscles that may appear anywhere in the muscular system. Though a wide array of accessory and supernumery muscles involving the ankle have been described in the literature, this is the first reported case we are aware of that features two accessory muscles. Accessory muscles are typically asymptomatic and often picked up as incidental findings but are important to be identified in the presence of chronic persistent ankle pain and the absence of other more common aetiologies.
Fulltext A review of occupational Injury research In Malaysia

Ganesh CS, Krishnan R

Med J Malaysia, 2016 06;71(Suppl 1):100-104.
PMID: 27801392 MyJurnal

A literature review of 16 papers on occupational injury research in Malaysia published during a 13-year period from 2000-2013 was carried out. The objective of this review and article selection was based on relevance to the research theme and mention of areas for future research. Most of the publications have focused on descriptive epidemiology, management practices, worker's knowledge, attitude, training, and rehabilitation services. The transportation, agriculture and construction sectors were found to be the most hazardous sectors and would benefit the most from Occupational Safety & Health (OSH) research and interventions. There is a strong need to develop a national injury surveillance system and also a mechanism to ensure adherence to the Occupational Safety & Health Act(OSHA) 1994. Detailed description and identification of risk factors for occupational injury in the environment, including machinery and equipment used was generally lacking. Future research on occupational injury should focus on surveillance to determine the magnitude of occupational injuries, determination of risk factors, identifying costeffective interventions (such as enforcement of OSHA regulations), and assessment of rehabilitation services. Relevant government agencies, universities, corporate sector and occupational safety organizations need to play a proactive role in identifying priority areas and research capacity building. Funding for occupational injury should be commensurate with the magnitude of the problem.
Fulltext A review of acute rheumatic fever and rheumatic heart disease research in Malaysia

Hung LC, Nadia R

Med J Malaysia, 2016 06;71(Suppl 1):79-86.
PMID: 27801390 MyJurnal

A total of 39 titles related to rheumatic fever or rheumatic heart disease in Malaysia were found with online literature search dating back to their inceptions and through 2014. Additional publications from conference journals were included. Nine papers were selected based on clinical relevance and future research implications. There were no population-based studies on the incidence or prevalence of ARF or RHD. In the 1980s, the incidence of admission due to ARF ranged from 2 to 21.1 per 100 000 paediatric admission per year. The burden of disease was significant in the adult population; 74.5% of patients with RHD were female, of which 77.1% were in the reproductive age group of 15-45 years old. Rheumatic mitral valve disease constituted almost half (46.7%) of all mitral valve repairs, ranging from 44.8 - 55.8 patients per year from 1997 - 2003. From 2010-2012, mitral valve interventions increased to 184 per year, of which 85.7% were mitral valve repair. In children with ARF, 25.4% - 41.7% had past history of rheumatic fever or RHD. In patients with rheumatic mitral valve disease undergoing surgical or medical interventions, only 6% reported history of ARF, none had history of GABHS pharyngitis or antibiotic prophylaxis. Only 44.7% of patients with RHD on follow-up were on intramuscular benzathine penicillin prophylaxis. Overall, there is scarcity of publications on ARF and RHD in Malaysia. Priority areas for research include determination of the incidence and prevalence of ARF and RHD, identification of high-risk populations, evaluation on the implementation and adherence of secondary preventive measures, identification of subclinical RHD especially amongst the high-risk population, and a surveillance system to monitor and evaluate preventive measures, disease progression and outcomes.
Fulltext A review of stroke research in Malaysia from 2000 - 2014

Cheah WK, Hor CP, Abdul Aziz Z, Looi I

Med J Malaysia, 2016 Jun;71(Suppl 1):58-69.
PMID: 27801388

Over 100 articles related to stroke were found in a search through a database dedicated to indexing all literature with original data involving the Malaysian population between years 2000 and 2014. Stroke is emerging as a major public health problem. The development of the National Stroke Registry in the year 2009 aims to coordinate and improve stroke care, as well as to generate more data on various aspects of stroke in the country. Studies on predictors of survival after strokes have shown potential to improve the overall management of stroke, both during acute event and long term care. Stroke units were shown to be effective locally in stroke outcomes and prevention of stroke-related complications. The limited data looking at direct cost of stroke management suggests that the health economic burden in stroke management may be even higher. Innovative rehabilitation programmes including braincomputer interface technology were studied with encouraging results. Studies in traditional complementary medicine for strokes such as acupuncture, Urut Melayu and herbal medicine were still limited.
A Review of Coronary Artery Disease Research in Malaysia

Ang CS, Chan KM

Med J Malaysia, 2016 06;71(Suppl 1):42-57.
PMID: 27801387 MyJurnal

Coronary artery disease is the major cause of mortality and morbidity in Malaysia and worldwide. This paper reviews all research and publications on coronary artery disease in Malaysia published between 2000-2015. 508 papers were identified of which 146 papers were selected and reviewed on the basis of their relevance. The epidemiology, etiology, risk factors, prevention, assessment, treatment, and outcomes of coronary artery disease in the country are reviewed and summarized. The clinical relevance of the studies done in the country are discussed along with recommendations for future research.
Fulltext Patients' blood pressure control and doctors' adherence to hypertension clinical practice guideline in managing patients at health clinics in Kuala Muda district, Kedah

Teoh SH, Razlina AR, Norwati D, Siti Suhaila MY

Med J Malaysia, 2017 02;72(1):18-25.
PMID: 28255135

BACKGROUND: blood pressure (bP) control among Malaysian is poor and doctor's adherence to clinical practice guideline (cPG) has been a well-known factor that may improve it. this study was designed to evaluate patients' bP control, doctors' adherence to the latest hypertension cPG and their association. Factors associated with bP control and cPG adherence was also examined.

METHODS: A cross-sectional study was conducted in Kuala Muda district's health clinics. 331 medical records were selected using stratified random sampling and standard proforma was used for data collection. the latest edition of the Malaysian cPG on hypertension was employed to define related variables.

RESULTS: A total of 160 patients (48.3%) had controlled bP and it was significantly associated with patients' age (adjusted Odds ratio, aOr= 1.03, 95% cI: 1.004, 1.05, p= 0.016) and systolic bP at presentation (aOr= 0.95, 95% cI: 0.93, 0.96, p< 0.001). About 60.7% of the medical records showed doctor's good level of cPG adherence. this adherence has significant association with presence of chronic kidney disease (aOr= 0.51, 95% cI: 0.31, 0.85, p= 0.007) and cardiovascular disease (aOr= 2.68, 95% cI: 1.04, 6.95, p= 0.030) in the patients and physicians' treatment intensification (aOr= 2.00, 95% cI: 1.26, 3.19, p= 0.009). However, no association was found between bP control and cPG adherence.

CONCLUSION: Hypertension control in this study was poor and the prevalence of physicians with good level of cPG adherence was slightly above average. these findings are important for relevant stakeholders to strategise an action plan to improve hypertension management outcome.
Prevalence and predictors of pediculosis capitis among primary school children in Hulu Langat, Selangor

Lye MS, Tohit NF, Rampal L

Med J Malaysia, 2017 02;72(1):12-17.
PMID: 28255134 MyJurnal

INTRODUCTION: Pediculosis capitis infestation is endemic in both developing and developed countries leading to various physical, economical and psychological consequences. Our main objective was to determine the prevalence and predictors of pediculosis capitis among primary school children in Hulu Langat District, Malaysia.
METHODS: An analytic cross-sectional study using cluster random sampling method was carried out in Hulu Langat District, Malaysia. Self-administered pretested questionnaires were used to collect the data. Hair and scalp examination was also carried out. Multivariate logistic regression was used to control for potential confounding and determine the predictors.
RESULTS: The overall mean age of the 1,336 respondents was 9.3 years. Majority were males (52.8%), Malays (79.5%) and 81.3% of the fathers had secondary or tertiary education as compared to 77.3% for the mothers. The overall prevalence of pediculosis capitis was 15.3%. The prevalence of pediculosis was significantly higher among females (28.4%) than males (3.7%, p=0.001). Multivariate logistic regression analysis showed that age 10 years or more (Odds Ratio (OR) = 2.34, 95% Confidence Interval (CI) = 1.673 to 3.272), female gender (OR = 10.26, 95% CI = 6.620 to 15.903), history of contact with an infested person (OR = 2.11, 95% CI = 1.506 to 2.960), Indian compared to Chinese (OR = 3.55, 95% CI = 1.282 to 9.860), Malay to Chinese (OR = 2.59, 95% CI = .994 to 6.774) were associated with pediculosis capitis.
CONCLUSIONS: Prevalence of pediculosis capitis among children aged 7 - 12 years in Hulu Langat District was high. There is a need for screening and treatment of pediculosis capitis in primary schools.
Clinical spectrum of children receiving palliative care in Malaysian Hospitals

Chong LA, Khalid F, Khoo TB, Teh SH, Kuan GL, Aina Mariana AM, et al.

Med J Malaysia, 2017 02;72(1):32-36.
PMID: 28255137 MyJurnal

INTRODUCTION: Awareness for paediatric palliative care has resulted in the impetus for paediatrician-led palliative care services across Malaysia. However, there is paucity of local data on patients receiving hospital-based paediatric palliative care. We aim to review the clinical spectrum of patients referred to these services.
METHODS: An observational study of children aged between 0-18 years receiving palliative care at 13 hospitals between 1st January and 31st December 2014 was carried out.
RESULTS: There were 315 patients analysed, 90 (28.6%) and 46 (14.6%) were neonates and adolescents respectively. The main ICD-10 diagnostic categories for all patients were identified to be 'Congenital malformations, deformations and chromosomal abnormalities' 117 (37.1%), 'Diseases of nervous system' 76 (24.1%) and 'Neoplasms' 60 (19.0%). At referral 156 (50%) patients had holistic needs assessments. Patients with 'Diseases of nervous system' were assessed to have significantly more physical needs than the other two diagnostic categories. Majority of patients who knew of their diagnosis and prognosis were those with malignancy. Over a fifth of referrals were at their terminal admission. Of 144 who died, 111 (77.1%) had advanced care plans. There was bereavement follow-up in 98 (68.1%) patients.
CONCLUSION: Patients referred for palliative care have varied diagnoses and needs. To ensure all paediatricians are competent to deliver quality care to all children, further education and training initiatives is imperative.
Attitudes, barriers and facilitators to the conduct of research in government hospitals: a cross-sectional study among specialists in government hospitals, northern states of Malaysia

Teh LC, Prema M, Choy MP, Letchuman GR

Med J Malaysia, 2017 02;72(1):26-31.
PMID: 28255136 MyJurnal

INTRODUCTION: Specialists constitute a major 'driving force' and catalyst for growth of research in their speciality. A clearer understanding is required as to what motivates their participation in research as well as the barriers they faced. This research aims to study the attitudes, barriers and facilitators faced by specialists and to identify strategies to promote and sustain research activities in their hospitals.
METHODOLOGY: A cross-sectional survey using selfadministered questionnaires was conducted among all specialists working in government specialist hospitals in the northern states of Malaysia.
RESULTS: Out of 733 questionnaires distributed, 467 were returned giving a response rate of 63.7%. Ninety-nine percent of the respondents believed that research benefits patients while 93.3% think research helps in their professional development. However, 34.8% think that under their present working conditions, it is unlikely they will participate in research. The major barriers identified were lack of funds for research (81%); lack access to expertise, software or statistical analysis (78.4%); interference with daily work schedule (75.1%) and inconsistent manpower in their department (74.2%). There are three barriers with statistically significant difference between hospitals with CRC compared to hospitals without CRC; lack of funds, mentors and access to expertise, software or statistical analysis. The demographic factors, attitudes and barriers contributing to involvement in research also investigated. The main facilitators for the conduct of research are potential to benefit patients and potential for professional development.
CONCLUSION: Taking note of the findings, the Ministry of Health can implement appropriate strategies to improve specialist participation in research.
Fulltext Effectiveness of selective risk based screening for gestational diabetes (GDM) in Malaysia: A retrospective cohort study based on the National Obstetric Registry (NOR) of Malaysia

Muniswaran G, Soelar SA, Karalasingam SD, Bujang MA, Jeganathan R, Suharjono H

Med J Malaysia, 2017 02;72(1):46-49.
PMID: 28255139 MyJurnal

INTRODUCTION: Gestational diabetes (GDM) has significant maternal and foetal implications. screening allows active interventions which significantly improves pregnancy outcomes. Despite World Health Organization (WHO), FIGO and National Institute of clinical Excellence (NIcE) recommendations for universal screening especially among high risk population; Malaysia currently adopts a selective risk based screening for GDM.
OBJECTIVE: the objective is to audit the effectiveness of the current practice of selective risk based screening in detection of GDM in Malaysia.
METHODOLOGY: this is a retrospective cohort study based on the National Obstetric Registry (NOR) which comprises of 14 major tertiary hospitals in Malaysia. the study period was from 1st January 2011 till 31st December 2012 and a total of 22,044 patients with GDM were analysed. Logistic regression analysis was used to calculate the crude odd ratio.
RESULTS: the incidence of GDM in Malaysia is 8.4%. Maternal age of ≥25, booking bMI ≥27kg/m2, booking weight ≥80kg and previous hypertension are non-significant risk of developing GDM in Malaysia. Parity 5 and more was only associated with an odds-ratio of 1.02 (95% confidence Interval: 0.90-1.17) as compared to parity below 5. the association of women with previous stillbirth with GDM was not significant.
CONCLUSION: current risk based screening for GDM based on maternal age, booking bMI, weight and hypertension is inappropriate. An ideal screening tool should precede disease complications, which is the novel objective of screening. Universal screening for GDM in Malaysia may be a more accurate measure, especially with regards to reducing maternal and foetal complications.
Towards developing high-fidelity simulated learning environment training modules in audiology

Dzulkarnain AA, Rahmat S, Mohd Puzi NA, Badzis M

Med J Malaysia, 2017 02;72(1):37-45.
PMID: 28255138 MyJurnal

INTRODUCTION: This discussion paper reviews and synthesises the literature on simulated learning environment (SLE) from allied health sciences, medical and nursing in general and audiology specifically. The focus of the paper is on discussing the use of high-fidelity (HF) SLE and describing the challenges for developing a HF SLE for clinical audiology training.
METHODS: Through the review of the literature, this paper discusses seven questions, (i) What is SLE? (ii) What are the types of SLEs? (iii) How is SLE classified? (iv) What is HF SLE? (v) What types of SLEs are available in audiology and their level of fidelity? (vi) What are the components needed for developing HF SLE? (vii) What are the possible types of HF SLEs that are suitable for audiology training? Publications were identified by structured searches from three major databases PubMed, Web of Knowledge and PsychInfo and from the reference lists of relevant articles. The authors discussed and mapped the levels of fidelity of SLE audiology training modules from the literature and the learning domains involved in the clinical audiology courses.
RESULTS: The discussion paper has highlighted that most of the existing SLE audiology training modules consist of either low- or medium-fidelity types of simulators. Those components needed to achieve a HF SLE for audiology training are also highlighted.
CONCLUSION: Overall, this review recommends that the combined approach of different levels and types of SLE could be used to obtain a HF SLE training module in audiology training.
Follicular thyroid cancer with sternal metastasis - challenges and outcomes

Syazni MA, Gendeh HS, Kosai NR, Ramzisham AR, Gendeh BS, Basiron NH, et al.

Med J Malaysia, 2017 02;72(1):80-82.
PMID: 28255152 MyJurnal

Sternal metastasis from differentiated thyroid carcinoma (DTC) is rare and presents a conundrum for surgeons. We present a lady diagnosed with follicular thyroid carcinoma and sternal metastasis who underwent thyroidectomy, sternectomy and sternoplasty with titanium mesh and acrylic plate. She developed a surgical site infection, of which multiple conservative approaches were attempted. She eventually required removal of the implant. Closure of sternal defect was completed with bilateral pectoralis major advancement flaps. This article highlights a series of complications faced during the course of treatment and how they were managed in a tertiary healthcare centre.
Abdominal wall necrotising fasciitis: A rare but devastating complication of the percutaneous endoscopic gastrostomy procedure

Mohd Said MR, Abdul Rani R, Raja Ali RA, Ngiu CS

Med J Malaysia, 2017 02;72(1):77-79.
PMID: 28255151 MyJurnal

Percutaneous Endoscopic Gastrostomy (PEG) tubes were often offered to patients requiring long term enteral feeding. Even though the procedure is relatively safe, it is associated with various complications such as peritonitis or even death.1 We presented a case of a 54-year-old gentleman with underlying ischemic stroke and pus discharges from a recently inserted PEG tube. Computed Topography (CT) scan confirmed abdominal wall necrotising fasciitis complicated with hyperosmolar hyperglycaemia state (HHS) and later succumbed after 48 hours of admission. Our case illustrated the rare complication related to the insertion of PEG tube; abdominal wall necrotising fasciitis that was associated with mortality.
Fulltext Bilateral fracture of prostheses post-hip replacement

Surinder S, George P

Med J Malaysia, 2017 02;72(1):71-72.
PMID: 28255148 MyJurnal

Fracture of hip prostheses is a rare occurrence. A case of bilateral hip prostheses fracture is described here. The need to follow-up and remain vigilant post hip replacement is highlighted.

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links