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  1. Fulltext Monsoon and primary acute angle closure in Malaysia
    Ch'ng TW, Mosavi SA, Noor Azimah AA, Azlan NZ, Azhany Y, Liza-Sharmini AT
    Med J Malaysia, 2013 Oct;68(5):410-4.
    PMID: 24632871 MyJurnal
    INTRODUCTION: Acute angle closure (AAC) without prompt treatment may lead to optic neuropathy. Environmental factor such as climate change may precipitate pupillary block, the possible mechanism of AAC.

    OBJECTIVE: To determine the association of northeast monsoon and incidence of AAC in Malaysia.

    MATERIALS AND METHODS: A retrospective study was conducted on AAC patients admitted to two main tertiary hospitals in Kelantan, Malaysia between January 2001 and December 2011. The cumulative number of rainy day, amount of rain, mean cloud cover and 24 hours mean humidity at the estimated day of attack were obtained from the Department of Meteorology, Malaysia.

    RESULTS: A total 73 cases of AAC were admitted with mean duration of 4.1SD 2.0 days. More than half have previous history of possibility of AAC. There was higher incidence of AAC during the northeast monsoon (October to March). There was also significant correlation of number of rainy day (r=0.718, p<0.001), amount of rain (r=0.587, p<0.001), cloud cover (r=0.637, p<0.001), mean daily global radiation (r=- 0.596, P<0.001), 24 hours mean temperature (r=-0.298, p=0.015) and 24 hours mean humidity (r=0.508, p<0.001) with cumulative number of admission for AAC for 12 calendar months.

    CONCLUSION: Higher incidence of AAC during northeast monsoon suggested the effect of climate as the potential risk factor. Prompt treatment to arrest pupillary block and reduction of the intraocular pressure is important to prevent potential glaucomatous damage. Public awareness of AAC and accessibility to treatment should be part of preparation to face the effect of northeast monsoon.
    Matched MeSH terms: Retrospective Studies
  2. Transtibial prosthesis suspension systems: systematic review of literature
    Gholizadeh H, Abu Osman NA, Eshraghi A, Ali S, Razak NA
    Clin Biomech (Bristol, Avon), 2014 Jan;29(1):87-97.
    PMID: 24315710 DOI: 10.1016/j.clinbiomech.2013.10.013
    Today a number of prosthetic suspension systems are available for transtibial amputees. Consideration of an appropriate suspension system can ensure that amputee's functional needs are satisfied. The higher the insight to suspension systems, the easier would be the selection for prosthetists. This review attempted to find scientific evidence pertaining to various transtibial suspension systems to provide selection criteria for clinicians.
    Matched MeSH terms: Retrospective Studies
  3. Fulltext Risk factors for women attending pre-pregnancy screening in selected clinics in Selangor
    Nik Mazlina M, Ruziaton H, Nuraini DB, Izan Hairani I, Norizzati Bukhary IB, Mohamad Rodi I, et al.
    Malays Fam Physician, 2014;9(3):20-6.
    PMID: 26425301 MyJurnal
    BACKGROUND: The Ministry of Health is committed to achieve Millenium Development Goal (MDG) MDG 4 and 5 by 2015 and include pre-pregnancy care as a strategy. This study evaluates the risk factors detected during the pre-pregnancy screening at selected public primary care clinics in Selangor.
    OBJECTIVES: The objectives of this study were to determine the proportion of women with risk factors receiving pre-pregnancy care in selected clinics in Selangor, their socio demographic features, the types of risk factors detected and their significance.
    METHODS: A retrospective review using secondary data was carried out from the month of March until June 2013 in four public primary care clinics in Klang and Petaling districts of Selangor. Data were obtained through non-probability sampling, using the pre-pregnancy screening form utilised in 2012, which is a standard questionnaire to determine the presence of risk factors. Women with at least one defined risk factor were considered as being at risk of an adverse obstetric outcome. Data were analysed using SPSS version 16.
    RESULTS: A total of 840 pre-pregnancy screening forms were collected. However only 614 (73.1%) were analysed and studied. The proportion of women with at least one risk factor was 68.8% (95% CI: 65.1, 72.5). The majority was Malays who had tertiary education and earned more than RM 1000. Most were in the reproductive age group of 18-35 years old (350, 82.9%). The mean age was 28.68 + 5.78 years. Most of the women were parous (259, 65.1%) and did not practice any form of contraception (308, 80.8%) despite having risks. The percentage of those not receiving any form of immunisation was small i.e. 9.8% but it was of importance and needed to be addressed prior to the conception. This study did not reveal any person with mental disorder or those who endured domestic abuse. Additionally, 3% (12) of them had unhealthy lifestyle habits, which include smoking, alcohol and substance abuse. Approximately one-third (212, 35.2%) of the women screened were overweight and obese, putting them at risk of developing gestational diabetes mellitus, pregnancy induced hypertension or deep vein thrombosis. The mean body mass index (BMI) for those at risk was 25.36 + 5.94 compared to 21.06 ± 1.46 for those with no risk. This study also found a small percentage of women with raised blood pressure (3.9%), abnormal physical examination (1.5%) and anaemia (14.4%), which need to be investigated and treated prior to conception.
    CONCLUSION: More than half of the women who attended the pre-pregnancy screening were found to have at least one risk factor.
    Matched MeSH terms: Retrospective Studies
  4. Treatment stability of Milwaukee brace in idiopathic hyperkyphosis
    Mehdikhani M, Behtash H, Ganjavian MS, Abu Osman NA, Khalaj N
    Prosthet Orthot Int, 2014 Aug;38(4):316-20.
    PMID: 23950552 DOI: 10.1177/0309364613499063
    The Milwaukee brace is an efficient method for correcting hyperkyphosis before skeletal maturity. However, loss of correction in long-term follow-up is inevitable.
    Matched MeSH terms: Retrospective Studies
  5. Fulltext Emergency thoracotomy and major lung resection for penetrating chest trauma: Lessons learnt from a review of three cases
    Sachithanandan A, Fahmi PA, Faisal I, Badmanaban B, Abdul Muis J, Mohd Arif MN
    Med J Malaysia, 2013 Jun;68(3):227-30.
    PMID: 23749011 MyJurnal
    Emergency lung resection for chest trauma is a rare event with a reported incidence of 0.08-1.3% but is associated with a high morbidity and mortality especially if a pneumonectomy is required, if due to blunt chest trauma or when concomitant injuries are present. We report three cases of young adult males with penetrating chest injuries that required emergency thoracotomy (ET) and anatomical lung resection to achieve definitive control of life threatening pulmonary haemorrhage. All patients survived to hospital discharge and remained well on follow-up. Indications for an ET and what constitutes the optimal operative management of such patients is discussed.
    Matched MeSH terms: Retrospective Studies
  6. Fulltext Topical insulin for healing of diabetic epithelial defects?: A retrospective review of corneal debridement during vitreoretinal surgery in Malaysian patients
    Bastion ML, Ling KP
    Med J Malaysia, 2013 Jun;68(3):208-16.
    PMID: 23749008 MyJurnal
    PURPOSE: To investigate whether topical insulin improves healing rate of corneal epithelial erosions induced during vitreoretinal surgery in diabetics.
    METHODS: We retrospectively reviewed case notes and serial post-operative photographs of 15 eyes of 14 patients who had corneal epithelial debridement performed during various vitreoretinal surgeries to improve one surgeon's view over a 10 month period in 2010.
    RESULTS: Three groups were identified: DTI, comprising diabetics who received topical insulin 1 unit qds postoperatively (n=5); DCT comprising diabetics treated with conventional post-operative medications only (n=5) and NDCT comprising non diabetic patients on conventional post operative therapy (n=5). Only eyes in which the corneal epithelial defect had been serially photographed at time, t= 0, 12, 24, 36, 48, 60, 72 and 120 hours following commencement of topical medications were included. The size of the defect was calculated using local software. DTI eyes had a significantly smaller defect size at t= 24 (p=0.009), 36 (p=0.009), 48 (p=0.015) and 60 hours (p=0.005) compared to DCT eyes and had no statistical difference from NDCT eyes at all times in the Mann Whitney U analysis (p>0.05). In the diabetic operated bilaterally, the insulin treated eye re-epithelialised by 48 hours whereas fellow eye treated conventionally re-epithelialised in 72 hours.
    CONCLUSIONS: Topical insulin or insulin eye drops 1 unit qds may be applied to the corneal surface to normalize the rate of healing of epithelial defects in diabetic patients undergoing epithelial debridement to improve the surgeon's view.
    Matched MeSH terms: Retrospective Studies
  7. Fulltext Predictors of mortality in patients with Acute Coronary Syndrome (ACS) undergoing Percutaneous Coronary Intervention (PCI): Insights from National Cardiovascular Disease Database (NCVD), Malaysia
    Ponniah JP, Shamsul AS, Adam BM
    Med J Malaysia, 2012 Dec;67(6):601-5.
    PMID: 23770953 MyJurnal
    The aim of this study is to determine risks factor of mortality among patient with post percutaneous coronary intervention. Estimation of post operative mortality risk factor is essential for planning prevention modalities. This is retrospective cohort study based on secondary data extracted from the National Cardiovascular Disease Database (NCVD-ACS and NCVD PCI). Both these registries were interlinked and was further matched to JPN (Jabatan Pendaftaran Negara/National registration Department) to assess mortality among the patients who underwent PCI and all death which occurred in between 2007, 2008 and 2009. There were 630 patients in this studied. Age, history of diabetes mellitus, peripheral vascular, renal failure and previous percutaneous coronary intervention were univariately associated with mortality. However based on logistics stepwise method, only age and history of renal failure had showed statistically significant and sizeable odds ratio in predicting the patient died of coronary death. Older age and renal failure are the predicting factors for mortality among patients with post percutaneous coronary intervention.
    Matched MeSH terms: Retrospective Studies
  8. Fulltext A case series of nasopharyngeal carcinoma among Indians, a low risk population, in Perak state, Malaysia
    Anusha B, Philip R, Norain K, Harvinder S, Gurdeep SM
    Med J Malaysia, 2012 Dec;67(6):641-3.
    PMID: 23770968 MyJurnal
    Nasopharyngeal carcinoma (NPC) is rare among people of Indian ethnicity. A short retrospective case review of clinical records of Indian patients diagnosed with nasopharyngeal carcinoma in a period of 5 years was conducted. Their slides were further subjected to EBV encoded RNA (EBER) - In- situ Hybridization (ISH). The histologic subtype was nonkeratinizing carcinoma in all 4 patients. All were Epstein Barr Virus (EBV) positive. We believe that the crucial factor responsible for nasopharyngeal carcinoma is genetics; either a genetic susceptibility among high risk groups or genetic resistance/immunity in low risk groups. Further genetic studies are required to look for somatic or inherited chromosomal mutations among the various risk populations.
    Matched MeSH terms: Retrospective Studies
  9. Fulltext Medical care costs of newly diagnosed children with structural-metabolic epilepsy: a one year prevalence-based approached
    Salih MR, Bahari MB, Shafie AA, Hassali MA, Al-lela OQ, Abd AY, et al.
    Seizure, 2012 Dec;21(10):764-9.
    PMID: 22939458 DOI: 10.1016/j.seizure.2012.08.005
    Aims of this study were to estimate the first-year medical care costs of newly diagnosed children with structural-metabolic epilepsy and to determine the cost-driving factors in the selected population.
    Matched MeSH terms: Retrospective Studies
  10. Fulltext Acral melanoma of the extremities: a study of 33 cases Sarawakian patients
    Zainal AI, Zulkarnaen M, Norlida DK, Syed Alwi SA
    Med J Malaysia, 2012 Feb;67(1):60-5.
    PMID: 22582550
    Acral melanoma involve the non-pigmented palmoplantar and subungual areas and are commonly seen among Asians. Patients commonly display advanced stage of disease at presentation. It may appear unnoticed and mimic benign lesions.
    Matched MeSH terms: Retrospective Studies
  11. Fulltext An audit of reported acute transfusion reactions in Universiti Kebangsaan Malaysia Medical Centre
    Rabeya Y, Abdul-Kahar AH, Leong CF
    Malays J Pathol, 2011 Jun;33(1):25-9.
    PMID: 21874748 MyJurnal
    Transfusion is an irreversible event which carries potential benefits as well as risk to the recipient. The objective of this study was to analyse all reported transfusion reactions of the year 2008 in the Blood Bank Unit of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). This is a retrospective study that was carried out by retrieving data from the laboratory information system. A total of 27842 transfusions were documented and the total reported transfusion reactions were 149. The incidence of transfusion reaction was 1 in 187 of all transfusions (0.54%); in which 69 (0.25%) were allergic in nature and 61 (0.22%) were febrile non-haemolytic transfusion reactions (FNHTR). Hypotensive reactions were identified in 6 (0.02%) patients. There were 9 (0.03%) cases reported with haemoglobinuria where no serological evidence of haemolytic transfusion reaction (HTR) was found. One HTR (0.003%) was identified and this was due to an error in patient identification in the ward. Other specified reactions like transfusion-related acute lung injury (TRALI), bacterial infections, Graft verses host disease (GVHD) were not reported. The highest frequency of the reactions occurred in the red cell transfusions which accounted for 111 cases. In conclusion, the incidences of transfusion reactions are low when compared to those reported by other centres.
    Matched MeSH terms: Retrospective Studies
  12. Fulltext An annual audit of the ear foreign bodies in Hospital Universiti Sains Malaysia
    Yaroko AA, Irfan M
    Malays Fam Physician, 2012;7(1):2-5.
    PMID: 25606237 MyJurnal
    Foreign bodies or objects in the ear are one of the most common problems encountered by otorhinolaryngologist (ORL) with attendant complications, removal of which requires expertise. Patients with this problem who sought treatment in the otorhinolaryngology clinic of Hospital Universiti Sains Malaysia (HUSM) were studied for duration of one year from January 2010 to December 2010. Specifically, the clinical presentation, type of foreign body and management outcome were analysed. 72 patients were reviewed - 44 (61.1%) males and 28 (38.9%) females. The age range was one year to 75 years with 59.8% being children below 10 years old. Ear pain (56.9%) was recorded as the most common and persistent symptom and insects (54%) were the commonest foreign body encountered. 95% (69) of the foreign bodies were removed under clinic setting with only three (4.2%) cases requiring general anaesthesia. Post-removal complications were noted in only one patient (1.4%). Repeated attempts by untrained personnel should be avoided and timely referral is vital to avoid undesirable complications.

    Study site: torhinolaryngology clinic of Hospital Universiti Sains Malaysia (HUSM)
    Matched MeSH terms: Retrospective Studies
  13. Fulltext Challenges in diagnosis and management of pseudoptosis secondary to asymmetrical skin creases
    Ting SL, Koay AC, Yew YH, Chua CN
    Med J Malaysia, 2011 Jun;66(2):121-3.
    PMID: 22106691 MyJurnal
    Asymmetrical eyelid skin crease may be mistaken for ptosis due to apparent narrowing of the palpebral fissure in the eye without the skin crease. This study describes a series of patients who were mistakenly referred for ptosis operation as a result of absent skin crease.
    Matched MeSH terms: Retrospective Studies
  14. Neck node bolus technique in the treatment of Nasopharyngeal Carcinoma with Intensity-modulated radiotherapy
    Phua CE, Ung NM, Tan BS, Tan AL, Eng KY, Ng BS
    Asian Pac J Cancer Prev, 2012;13(12):6133-7.
    PMID: 23464418
    PURPOSE: To study the effect of bolus versus no bolus in the coverage of the nodal tumour volume with intensity-modulated radiotherapy (IMRT) for the treatment of nasopharyngeal carcinoma (NPC).

    METHODS AND MATERIALS: This retrospective study used data from 5 consecutive patients with NPC who were treated with bolus for large neck nodes using IMRT from November 2011-January 2012 in our institute. All these patients were treated radically with IMRT according to our institution's protocol. Re-planning with IMRT without bolus for these patients with exactly the same target volumes were done for comparison. Comparison of the plans was done by comparing the V70 of PTV70-N, V66.5 of PTV70-N, V65.1 of PTV70-N and the surface dose of the PTV70-N.

    RESULTS: The mean size of the largest diameter of the enlarged lymph nodes for the 5 patients was 3.9 cm. The mean distance of the GTV-N to the skin surface was 0.6 cm. The mean V70 of PTV70-N for the 5 patients showed an absolute advantage of 10.8% (92.4% vs. 81.6%) for the plan with bolus while the V66.5 of PTV70-N had an advantage of 8.1% (97.0% vs. 88.9%). The mean V65.1 also had an advantage of 7.1% (97.6% vs. 90.5%). The mean surface dose for the PTV70-N was also much higher at 61.1 Gy for the plans with bolus compared to only 23.5 Gy for the plans without bolus.

    CONCLUSION: Neck node bolus technique should be strongly considered in the treatment of NPC with enlarged lymph nodes treated with IMRT. It yields a superior dosimetry compared to non-bolus plans with acceptable skin toxicity.

    Matched MeSH terms: Retrospective Studies
  15. Fulltext Associated factors affecting the successful pregnancy rate of intrauterine insemination at International Islamic University Malaysia (IIUM) Fertility Centre
    Azantee YW, Murad ZA, Roszaman R, Hayati MY, Norsina MA
    Med J Malaysia, 2011 Aug;66(3):195-8.
    PMID: 22111439 MyJurnal
    The aim was to determine pregnancy rate and its associated factors in Intrauterine Insemination (IUI) at IIUM Fertility Centre.
    Matched MeSH terms: Retrospective Studies
  16. Off-pump Coronary artery bypass graft surgery in patients with left main stem disease
    Ishamuddin IM, Zamrin DM, Joanna OS, Ramzisham AR, Hairolfaizi H
    Clin Ter, 2011;162(6):527-31.
    PMID: 22262322
    The safety, feasibility and post-operative outcome are the main concern in Off-pump Coronary artery bypass graft (OPCAB) surgery as compared to conventional technique especially in multi-vessels coronary artery disease.
    Matched MeSH terms: Retrospective Studies
  17. Fulltext The Adjunctive Use of Anti-vascular Endothelial Growth Factor Agents in the Management of Iris Neovascularisation in Malaysia
    Bastion ML, Then KY, Faridah HA, Mushawiahti M, Othmaliza O, Wong HS
    Med J Malaysia, 2011 Mar;66(1):10-4.
    PMID: 23765135 MyJurnal
    This retrospective study investigated the role of antivascular endothelial growth factor agents (VEGF), ranibizumab, bevacizumab and pegaptanib sodium in patients with iris neovascularisation (INV), in which 9 eyes received intraocular injections for various ischaemic ocular conditions. Ocular sequelae included recurrence of rubeosis (n=2) and hyphaema (n=2). Systemic complication included one case of cerebrovascular accident. INV regressed in all cases from day one. INV recurrence occurred in 2 cases. The mean intraocular pressure of the study eyes decreased from 25.3 mmHg to 18.3 mmHg at one month. Five eyes are medication free. Visual acuity improved in 5 eyes. Four eyes achieved a Snellen visual acuity of 6/24 or better. We conclude that the use of intraocular anti-VEGF agents are safe and effective for inducing the regression of INV. Patients with multiple systemic risk factors should be counseled on stroke risk.
    Matched MeSH terms: Retrospective Studies
  18. Fulltext Adult allogeneic haematopoietic stem cell transplantation: a single centre experience in Malaysia
    Gan GG, Zakaria Z, Sangkar JV, Haris AR, Bee PC, Chin E, et al.
    Med J Malaysia, 2008 Oct;63(4):281-7.
    PMID: 19385485 MyJurnal
    We analysed the outcome of 104 patients from a single institution who underwent allogeneic haematopoietic stem cell transplantation (AHSCT) from their HLA-identical siblings between 1993 and 2006. Sixty-nine percent of patients had peripheral blood stem cell (PBSC) as the stem cell source and the remaining had bone marrow (BM). The majority of patients are Chinese (60%) followed by Malays (24%) and Indians (14%). The median time to reach white cell counts of >1 x 10(9)/L and platelet counts of >30 x 10(9)/L was 13 and 15 days, respectively in patients who had PBSC transplantation compared with 16 and 25 days in patients who had BM transplantation, (p < 0.0001 and p < 0.001). Acute graft-versus-host disease (aGVHD) of grade II to IV was observed in 34% of patients and chronic graft-versus-host disease (cGVHD) in 38% of patients. Although not statistically significant, there was a higher incidence of overall aGVHD in Indian patients (73%) compared to Chinese and Malays (57% and 56% respectively). There was no significant difference in the incidence of aGVHD and cGVHD with the source of stem cells. Overall survival (OS) and disease free survival (DFS) was 50% and 60% at five years respectively. Multivariate analysis showed that patients transplanted in standard risk and those who had limited cGVHD had a significant better OS, (p = 0.05 and p = 0.05). Patients who had cGVHD and transplanted in standard risk had a better DFS, (p = 0.002 and p < 0.001). In summary, AHSCT in standard risk patients is associated with a better outcome than those transplanted in high risk and although not statistically significant, there is a higher incidence of aGVHD in Indian patients.
    Matched MeSH terms: Retrospective Studies
  19. Age specific histologic types of carcinoma breast in Malaysians
    Sheikh MK, Khan FA, Imran Abdul Khalid IK, Kumar G
    J Coll Physicians Surg Pak, 2009 Mar;19(3):201-2.
    PMID: 19268026 DOI: 03.2009/JCPSP.201202
    The influence of age on various histological types of breast cancer at both age <50 years and >50 years to simulate menopause was studied retrospective from 2002 to 2004 in Malaysia. One hundred and fifty five cases were reviewed. Ninety two cases recorded at age <50 years, 60 (65.2%, 95%CI: 54.6 - 74.8%) were infiltrating ductal carcinoma in 11(12.0%, 95% CI: 6.1-20.4%), ductal carcinoma in situ (DCIS) in 9 (9.8%, 95% CI: 4.6-17.8%), medullary carcinoma in 6 (6.5%, 85%CI: 2.4-13.6%), invasive lobular carcinoma in 4 (4.3%, 95%CI: 1.2-10.8%), mucinous carcinoma and poorly differentiated carcinoma in 2 cases (2.2%, 95%CI: 0.3-7.6%). At >50 years of age, 63 cases were recorded. Forty seven (74.6%, 95%CI: 62.0- 84.7%) cases were of infiltrating ductal carcinoma, ductal carcinoma in situ in 9 (14.3%, 95%CI: 6.7-25.4%), mucinous carcinoma in 5 (7.9%, 95%CI: 2.6-17.6%), medullary carcinoma (8.5%) and papillary carcinoma in 1 case each (1.6%, 95%CI: 0.0-8.5%). Infiltrating ductal carcinoma was the commonest histology at both age <50 years and >50 years.
    Matched MeSH terms: Retrospective Studies
  20. An insight into industrial accidents involving the hand
    Abdullah S, Jaafar JM, Das S, Sapuan J
    Clin Ter, 2009;160(6):427-33.
    PMID: 20198282
    BACKGROUND: Industrial hand injuries are a common occurrence and contributes to a large segment of workers' morbidity. The main aim of this study was to look into the day pattern, types and location of upper limbs injures, identify the types of machines involved and highlight the treatment received.
    MATERIALS AND METHODS: The present study was performed on 57 industrial workers admitted and treated by the Orthopaedic team of Universiti Kebangsaan Malaysia Medical Centre (UKMMC) for acute injuries sustained whilst working.
    RESULTS: The majority of the workers were male (93%). The commonest age group involved was between 25-35 years (48%). The right hand was injured more then the left with majority of injuries involving the fingers. Interestingly, we also observed that injuries occurred more on Saturdays. Laceration was the most common injury followed by fractures and crush injuries. Treatment depends on the type and severity of injuries. For most lacerated wounds, treatment was debridement, primary suturing and antibiotic therapy. Injuries on Saturdays indicated that workers needed a longer time break especially during weekends after a long hectic week.
    CONCLUSIONS: Injuries sustained by workers may be prevented by proper working techniques and conditions together with wearing of protective gadgets.

    Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
    Matched MeSH terms: Retrospective Studies
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