Displaying publications 41 - 60 of 193 in total

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  1. Abilash Kumar, Jeffrey Jayaraj, Jacob Abraham, Premchandran Menon, Manohar Arumugam
    MyJurnal
    Post-operative complications are well known to impair the functional outcomes of total knee arthroplasty (TKA). Patella subluxations post-TKA is a grim complication rendering patients disable post-surgery. Howbeit, medial patella subluxation is a rarely recorded incident altogether. This case report describes a patient post successful TKA two years ago, who was incidentally diagnosed with a medial patellofemoral subluxation during a recent routine yearly follow up. This gentleman, however, had no complaints and the only evident clinical sign was anterior knee skin puckering. A radiograph of the knee confirmed our clinical suspicion of medial patella subluxation. The patient’s symptoms, his expectations, radiological findings, what went wrong during surgery and management of this rare entity were analysed. This rarely reported entity requires a high degree of suspicion especially if the patient complains of instability and peculiar anterior knee pain. Diagnosis is customarily clinical and revision surgery is almost invariably necessary.
  2. Sobani Din, Fadzilah Ismail, Teh, Carren Sui Lin, Raudha Ezaty Ruslan, Shiraz Qamil Muhammad Abdul Kadar, Azuin Izzati Arshad
    MyJurnal
    The current COVID-19 pandemic has forced many clinical disciplines to evolve to function safely and still provide the necessary care. Otorhinolaryngology (ORL) is a field that has been greatly affected by this highly transmissible viral pathogen. Aerosolizing procedures, proximity examination and other common procedures must be revamped to suit current time. The usual norm ORL procedures need also be altered to incorporate safeguards to protect both patient and healthcare workers. This recommendation for current practices aims to give a practical approach to modify current practices to maintain safety during the pandemic. These recommendations are the consensus amongst ORL practitioners in Hospital Sungai Buloh which is the designated COVID-19 centre for Malaysia’s central region and is currently being practised.
  3. Daisuke, Mori, Wahida Khanam, Kamruddin Ahmed
    MyJurnal
    Although mumps virus (MuVi) is an important agent of encephalitis, however, mumps vaccine has not yet been included in the national immunization programme of Bangladesh. Furthermore, the genotype distribution of this virus in Bangladesh is unknown. Cerebrospinal fluid samples collected from 97 children with encephalitis from April 2009 to March 2010 were subjected to polymerase chain reaction (PCR) test to determine the causative agents. MuVi was detected in two samples, these samples were further subjected to conventional PCR using specific primers, then amplicons were sequenced, and genotype was determined as genotype G. Phylogenetic analysis showed that these strains were clustered with strains from Nepal, India, the UK, Thailand, and the USA. By Bayesian inference, we also determined that the ancestor of Bangladeshi and Indian MuVi were same and segregated only about two decades back. These results will help future surveillance and the detection of invading MuVi strains from other countries.
  4. Muhammad Wafiuddin, Ahmad Faizal Roslan, Ahmad Hafiz Zulkifly
    MyJurnal
    Tuberculosis (TB) is an ancient disease dated back from ancient Greece time. Once rare in developed countries, now it has re-emerged due to immigration and secondary immunodeficiency. A 27-year-old lady had left knee pain for the past 4 years, went for knee diagnostic arthroscopy procedure, and diagnosed as pigmented villonodular synovitis (PVNS) of the left knee. Despite regular analgesics and physiotherapy, patient symptoms worsen. Two years after the initial treatment, the patient went for a further workout and diagnosed as knee tuberculosis, commenced on anti-TB treatment, the patient still left complicated with a stiff knee and fixed flexion deformity. Identification of knee tuberculosis during the initial phase is crucial as late diagnosis and treatment will leave the patient with debilitating complications.
  5. Amelia Inbam Neelagandan, Esther Tuin, Tay, Chia Yi, Rajesh Kumar Muniandy
    MyJurnal
    Swallowing involves 55 muscles, five cranial nerves and two cervical nerve roots. When the coordination of this reflex is disturbed, dysphagia occurs. Dysphagia refers either to the difficulty someone may have with the initial phases of a swallow or to the sensation that the foods or the liquids are being obstructed in their passage from the mouth to the stomach. The objective of the study was to identify the diagnosis of patients attending Speech Therapy clinic, in Queen Elizabeth Hospital, Kota Kinabalu, Sabah, and to identify the demography of dysphagic patients. From the 406 patients that came during the study period, 139 patients (34.2%) were diagnosed with dysphagia, followed by developmental language disorders (33.3%). Of the 139 patients diagnosed with dysphagia, most of them are within the 41 to 60 (43.2%) and above 60 (42.2%) age groups. The majority were males (66.2%). A total of 81 (58.3%) patients with dysphagia had a history of cerebrovascular accident. Dysphagia is a common disorder among patients attending Speech Therapy Clinics at Queen Elizabeth Hospital, Kota Kinabalu. Training of Speech Therapists and early dysphagia intervention leads to a better outcome.
  6. Alamgir Chowdhury, M., Farid Hossain Chowdhury, Khaled Bin Shahabuddin, Tofazzal Hossain, A.B.M., Shaila Kabir
    MyJurnal
    Complete or partial restriction of the vocal cords usually occurs due to cancer, neurologic causes or mechanical causes like huge neck mass, trauma to the neck, viral infection, and sometimes iatrogenic during surgery. Bilateral vocal cord palsy is a severe condition that can lead to significant problems in breathing, speaking, and swallowing. If any patient presents with stridor, it requires urgent surgical airway management followed by specific treatment. A case of viral bilateral abductor vocal cord palsy in a 41-year-old female is reported here. The patient presented with stridor, and immediate tracheostomy was done. The stridor developed first 3 months earlier followed by cold and fever for a week. The stridor worsened gradually and leads to a state of commencing immediate tracheostomy. There was no history of trauma to the neck or any neck surgery. All basic laboratory blood test was within the normal limit. The laryngoscopic examination showed both vocal cords were immobile and almost median position with a small gap at the posterior commissure. Chest and neck plain X-ray along with computed tomography scan of neck was normal which ruled out the other causes of bilateral vocal cord palsy. The patient subsequently underwent successful left posterior cordectomy by laser, and decannulation of tracheostomy was done, known as Kashima operation.
  7. Malay Kanti Mridha
    MyJurnal
    Since December 2019, COVID-19 is impacting the health, economy, education, and well-being of every country in the world. The total number of reported COVID-19 cases will soon surpass 100 million and the death toll will be more than 20 million. At this moment, the top 10 countries with the most reported number of cases currently are the USA, India, Brazil. Russia, UK, France, Turkey, Italy, Spain, and Germany. These countries altogether represent 31.7% of the world’s population. However, they reported 65.5% of the total COVID-19 cases and 58.9% of total deaths. For containing the spread of SARS-CoV-2, the virus that causes COVID-19, Malaysia was one of the most successful countries in the world. However, since September 2020, the situation in Malaysia started changing, and at this moment Malaysia is reporting more than 2,500 new cases per day. During the past year, all the countries in the world acted fast and took different initiatives to reduce transmission of SARS-CoV-2, find effective drugs that can improve the clinical outcomes of COVID-19, and invent vaccines that can give immune protection. The first vaccine that was approved was invented by Pfizer/BioNTech and in December 2020, within one year of the beginning of the pandemic, the UK was the first country to start mass vaccination. As reported by the World Health Organization (WHO) in January 2021, more than 50 COVID-19 vaccines were in different phases of clinical trial and five vaccines received certain national regulatory approval for mass vaccination. However, given all these developments the COVID-19 pandemic is still making a devastating impact on the whole world and the pandemic is not going to over soon. Therefore, we need to discuss what we can do now to deal with the pandemic and ensure the health and wellbeing of the citizens of the world.
  8. Md. Shamsur Rahman, David Matanjun, Urban John Arnold D’souza, Wan Salman Wan Saudi, Fairrul Kadir, Tan, Teck Song, et al.
    MyJurnal
    Irrational use of drugs could be detrimental issues in the practices of healthcare communities. This problem arises either because of the wrong prescription or inappropriate self-medication. Faulty prescribing practices and incorrect self-medication will lead to an ineffective treatment regime. Still, they can also be unsafe as these may exacerbate or prolong the illness and distress the patients. In turn, these will incur unnecessary treatment costs. The most typical issues in the irrational use of drugs are the patient’s lack of information about the medicine and inadequate proper consultation from physicians. Lack of regulation in the appropriate use and supply of drugs by the relevant enforcement agencies could also be the problem in the irrational use of drugs. Ulceration and inflammation due to the irrational use of NSAIDs, antibiotics, and unhealthy lifestyle may contribute to the novel therapeutic strategy challenges. The ability to purchase the drugs without a doctor’s prescription of nonsteroidal anti-inflammatory drugs (NSAIDs) was also the landmark event that became the most widely used medications for the anti-inflammatory, analgesic, and antipyretic effects. Inadequate knowledge from both drug providers and patients may contribute to the most recognized influential factors in the irrational use of drugs in various countries. The recommendation should introduce an appropriate educational intervention that can be designed to promote rational prescribing. Proper regulation on prescription practices by policymakers and physicians could be the way to ensure the standard of rational usage of drugs have compliant with the healthcare communities.
  9. Chieng, Jin Yu, Yasotha Sugumaran, Pan Yan
    MyJurnal
    Hepatitis B is a well-recognized occupational risk for healthcare workers. This self-administered questionnaire study was designed to assess awareness and knowledge towards hepatitis B virus infection among 140 nurses at Serdang Hospital, Selangor, Malaysia from the period of 1st April to 30th September 2017. The response rate was 97.2% (n = 140/144). A total of 71.4% of participants showed adequate awareness of hepatitis B. Most participants had heard hepatitis B with the predominant sources receiving from friends, media and education. Majority of them did serology blood test of hepatitis B before. A total of 84.3% of participants were aware of vaccine available for hepatitis B, although 78.6% got vaccinated in the past. Antiviral treatment of hepatitis B was not well noticed by most of them. Education qualification determines the awareness of hepatitis B. Regarding the knowledge, 73.6% of participants showed poor knowledge of hepatitis B. Most participants understood that hepatitis B was caused by a virus infection and the organ most affected was the liver. Surprisingly, 77.9% of them failed to recognize that cancer could be caused by hepatitis B. Majority of participants were aware that transmission of hepatitis B could be mediated via sexual intercourse, as well as childbirth. Nevertheless, 14.3% of them believed that hepatitis B was able to spread by cough and sneeze. Older age, Chinese ethnicity, and having high educational qualification were factors leading to adequate knowledge of hepatitis B. Additional attention should be emphasized to strengthen knowledge towards hepatitis B among nurses and perhaps other healthcare workers in Malaysia.
  10. Wynn AA, Myint O
    MyJurnal
    Malaria is a major health problem in various parts of the world especially affecting the tropical countries. It affects the vital organs causing severe complicated malaria. Clinical syndromes like severe cerebral anaemia, coagulation abnormalities, respiratory distress and severe anaemia can increase the mortality of malaria infected cases. Variation in individual susceptibility and severity and type of clinical presentations of malaria raises the need for study of both the parasite and host immune reactions as well as the contribution of inflammatory cytokines in malaria pathogenesis. This study explored the immunopathological basis and advances of severe malaria and their importance in pathogenesis of malaria and its complications. Previous and ongoing studies indicate that changes in endothelium during the sequestration of parasites in organs causes disruption of endothelial barrier function leading to serious effects of malaria. Parasite and host factors contribute to disturbance of cytokine regulation and escape of parasites from the immune system of the host. Immunopathological changes and dysregulation of cytokine production play central role in pathogenesis and disease severity in malaria.
  11. Loh, Li Loong, Wong, Kai Ann, Zamzuri Zakaria@Mohamad
    MyJurnal
    Synovial osteochondromatosis is an unusual, rare and benign tumour. This disease is characteristically monoarticular, most commonly found in knee joint, however it is rarely found in the elbow. A 49-year-old Indian man presented to hospital with a 6-month history of pain, swelling, intermittent locking, loss of range of motion of right elbow and a considerable size of elbow with no recollection of associated trauma. Plain radiographs of right elbow showed numerous radiopaque round and oval loose bodies within the right elbow joints. Computer Tomographic (CT) scan showed multiple bony mass within the right elbow joint. Arthroscopic synovectomy, debridement, excisional biopsy and loose body removal combined with miniarthrotomy of the right elbow was performed due to limited exposure for removal of larger loose bodies. Histopathological examination of the tissue sample is consistent with the diagnosis of synovial osteochondromatosis. The clinical and radiological evaluation at 6th month postoperatively showed marked reduction in the volume of the elbow, further improvement of elbow range of motion of this patient and the Mayo elbow performance score before surgery and at 6 months postoperative, with an increase from 50 to 80 points. Synovial osteochondromatosis of the joints is a rare condition. The signs and symptoms are not specific and may be suggestive of other pathology conditions. Arthroscopic synovectomy and removal of loose body is the standard operative procedure till today. However, combination of arthroscopy and miniarthrotomy in cases of large loose bodies may provide a good clinical and functional outcome.
  12. Go, Zher Lin, Low, Qin Jian, Nurul Aisyah Abd Rahman, Ng, Ling Fong, Faizah Ahmad, Lau, Ngee Siang
    MyJurnal
    Prurigo nodularis (PN) is an uncommon skin condition known to be associated with underlying systemic diseases. This case report is about PN secondary to underlying Hodgkin’s lymphoma. A 30-year-old man presented with this skin condition three months before lymphadenopathy and systemic symptoms due to lymphoma. He had made multiple visits to general practitioners for the disturbing rash, given multiple courses of topical treatment without relief. His PN showed marked improvement after initiation of chemotherapy. This case reminds that an unexplained skin condition should prompt clinicians for investigating for an underlying systemic disease. This case, to our knowledge, is the first Hodgkin’s lymphoma-associated prurigo nodularis reported in Malaysia.
  13. Balakrishnan, Yogambigai, Nor Hasnina Mohd Hassan, Wan Najwa Zaini Wan Mohamed
    MyJurnal
    Osteochondromyxoma is a rare bone tumour. Bone tumours of the talus are also uncommon, and accounts to be between 8% to 23% in tumours of the foot. A 28-year-old man presented with chronic right ankle pain. He had underlying left knee ligament and meniscal injury. Special examination tests for ligament injury were negative. Magnetic Resonance Imaging (MRI) revealed a benign bone lesion of talus with reactive oedema of sinus tarsi. Excision of lesion was done and subsequent histopathological examination confirmed the diagnosis of ostechondromyxoma.
  14. Pei, Yin Kang, Ho, Shuyan
    MyJurnal
    Ovarian carcinoma is the fifth common cause of cancer death among women in Malaysia, with five-year survival rates of 30%. It has been associated with delayed diagnosis, advanced stage of presentation and poor prognosis due to vague symptoms and lack of effective screening. The continued high fatality rate has underpinned efforts to develop effective screening tests and newer therapies that could impact on prognosis. New insights into proteomic analysis and genomic tests with a better understanding of the target lesion have leading to discovery of new treatment modalities in ovarian carcinoma. We present a 58-year-old lady with Stage IV ovarian cancer who had lower abdominal pain and mass, constipation and voiding frequency for six months duration. Ultrasound guided biopsy revealed serous adenocarcinoma likely ovarian in origin. CT scan showed gross ascites and right ovarian mass with infiltration to adjacent small bowel. Tumour markers CA 125 and LDH were high. She has received neoadjuvant chemotherapy followed by cytoreductive surgery and currently in remission.
  15. Low, Qin Jian, Hong, Eric Qiu Weng, Cheo Seng Wee
    MyJurnal
    Pernicious anaemia is an autoimmune disorder where vitamin B12 deficiency is caused by autoantibodies that interfere with vitamin B12 absorption by targeting intrinsic factor or parietal cells or both. It is commonly associated with anaemia, rarely pancytopenia. Here we reported two cases of pancytopenia due to undiagnosed pernicious anaemia. First case was a 26-year-old man presented with lethargy and reduced effort tolerance, associated with postural giddiness and palpitation. Clinically, he was pale with no other findings. On blood investigations, the patient was diagnosed pancytopenia secondary to pernicious anaemia. He was treated with daily subcutaneous injection of vitamin B12 cyanocobalamin 1 mg for one week followed by weekly injection for a month and subsequently with lifelong monthly subcutaneous injection. After receiving 2 weeks of B12 replacement, his full blood count had normalized and his symptoms resolved. Second case was a 65-year-old man presented with yellowish discolouration of the eyes with lethargy. On examination, he was pale with jaundice. On blood investigations, the patient was diagnosed pancytopenia secondary to pernicious anaemia. He was started with intramuscular injection of 1000 mcg vitamin B12 replacement daily for one week followed by monthly for 6 months. After one week of B12 replacement, his full blood count had normalized. He was started on lifelong 3 monthly injections of vitamin B12 replacement and he remained symptom free. Patients with pernicious anaemia often present with general signs and symptoms which occur insidiously. It is important that early diagnosis is made to avoid harmful complications such as neuropsychiatric disorders.
  16. Hanizah Ngadiron, Razrim Rahim, Firdaus Hayati, Nornazirah Azizan, Affirul Chairil Ariffin
    MyJurnal
    Hypophosphataemia occurs in an abnormally low serum phosphate level. Three main mechanisms are postulated: decreased intestinal absorption, increased renal excretion, and extracellular shifts to intracellular compartments. It is potentially a fatal disease if not intervene. The management is merely treating the underlying disorder, giving phosphate supplement and requiring close biochemical monitoring. The incidence of symptomatic isolated hypophosphataemia is extremely rare. In this case report, a 33-year-old man presented with three days history of dysphagia, inability to complete sentences and generalized muscle weakness. He developed blurred vision especially upon exposure to bright light. He had a history of single parathyroidectomy for parathyroid adenoma 2 years ago. Physical examinations were unremarkable. Laboratory investigations were normal except for phosphate level of 0.30 mmol/L. Intravenous KH2PO4 with a dosage of 10 mmol was administered in slow bolus in 3 hours. His symptoms resolved slowly after correction. Although isolated hypophosphataemia is rare but need to recognize the symptoms and signs of hypophosphataemia and treat accordingly.
  17. Payus, Alvin Oliver, Leow, Justin Wen Hsiang, Liew, Sat Lin, Malehah Mohd Noh
    MyJurnal
    Non-cirrhotic portal hypertension (NCPH) is clinically defined as the presence of portal hypertension in the background of non cirrhotic liver. It is diagnosed by the findings in ultrasound of the hepatobiliary system and also oesophagogastroduodenoscopy (OGDS) that consistent with that of a portal hypertension, but otherwise has a relatively normal liver function and echotexture. The treatment mainly focuses on primary and secondary prophylaxis of variceal bleeding both pharmacologically like non-selective beta-blockers and octreotide, and non-pharmacologically like endoscopic band ligation of varices and sclerotherapy. In advance cases, sometimes surgery such as Porto systemic shunt or splenectomy may be required especially in patients with uncontrolled variceal bleeding or with symptomatic hypersplenism. Here we report a case of a young man who presented with upper gastro-intestinal bleeding, which was initially thought from a bleeding ulcer but was found to be secondary to oesophageal and gastro-oesophageal varices. Apart from having mild ascites, he has no other features of portal hypertension. His liver biochemistry and echotexture were also normal. Unfortunately, the patient was lost to follow up while he was still in the early stage of investigating the condition. The purpose of this case report is to share an uncommon occurrence of NCPH in East Malaysia, where liver cirrhosis predominates the aetiology of portal hypertension. Also, to the best of our knowledge, there is a very limited reporting of a similar case in this region.
  18. Lim, Christopher, Mra, Aung, Chin, Suliong, Venkata Rao, Challa, Aung, Tun, Sieman, Jony, et al.
    MyJurnal
    This article will cover some of the most recent advances in the diagnosis of the world’s most common cancer in women, namely, breast cancer as we enter the era of precision medicine. The authors will discuss the differences between East and West pertaining to the incidence and mortality rates, the types of breast cancer and the revised staging criteria of breast cancer according to the American Joint Committee on Cancer (AJCC) Staging Manual, 8th edition. In addition, the advances of newer imaging modalities are presented and compared with traditional ultrasonography and mammography
  19. Jia, Ying Soo, Nur Ayub Mohd Ali, Aishath Azna Ali, Firdaus Hayati, Nornazirah Azizan, Andee Dzulkarnaen Zakaria, et al.
    MyJurnal
    Skeletal metastasis is a frequent complication of cancer resulting in significant morbidity as well as mortality. We highlight a case of a 73-year old gentleman with metastatic squamous cell carcinoma of the sternum. He denied dysphagia, shortness of breath, goitre, and presence of chronic non-healing ulcer. He was anaemic and carcinoembryonic antigen (CEA) was 18.7. Chest radiograph on lateral view showed a suspicious cortical irregularity. Computed tomography (CT) scan of thorax revealed an aggressive sternal lesion with soft tissue component. Ultrasound guided biopsy was performed and the biopsy was consistent with metastatic squamous cell carcinoma. Squamous cell carcinoma has a predilection to metastasize via haematogenous spread, but direct extension of tumour into the bone is not frequently seen. Finding the primary cause is utmost importance either via imaging modalities or invasive procedures. Isolated secondary lesion is extremely rare but unfortunate among defaulters. We discuss its diagnostic work-up and treatment options conserved to manage this condition.
  20. Shaiful Ehsan Shalihin, Mohamad Haniki NM
    MyJurnal
    The number of active smokers in Malaysia is increasing despite the availability of stop smoking clinics and smoking cessation medications. Other than smokers’ level of motivation to quit smoking, competency of the healthcare professionals involved in providing smoking cessation intervention using evidence based guidelines needs to be considered. Hence, knowledge, attitude and practice (KAP) of the healthcare providers in relation to existing clinical practice guidelines on smoking cessation should be assessed. In this review, we look at the factors contributing to the KAP of medical personnel on the guidelines and also the previously available assessment tool, mainly in the form of a validated questionnaire, for the purpose of applying it to the context of the Malaysian healthcare providers.
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