Displaying publications 41 - 60 of 12258 in total

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  1. Intravesical explosion during transurethral resection of the prostate
    Dublin N, Razack AH, Loh CS
    ANZ J Surg, 2001 Jun;71(6):384-5.
    PMID: 11409027
    Matched MeSH terms: Aged; Aged, 80 and over
  2. Avulsed ureter
    Dublin N, Razack AH
    ANZ J Surg, 2003 Apr;73(4):254-5.
    PMID: 12662241
    Matched MeSH terms: Middle Aged
  3. External laryngeal nerve in thyroid surgery: recognition and surgical implications
    Aina EN, Hisham AN
    ANZ J Surg, 2001 Apr;71(4):212-4.
    PMID: 11355727
    Injury to the external laryngeal branch of the superior laryngeal nerve during thyroid surgery is not uncommon. Most surgeons tend to avoid rather than expose and identify the external laryngeal nerve (ELN). The aim of the present study was to analyse the frequency and types of ELN crossing the avascular space in relationship to the structures to the upper pole of the thyroid and related thyroid pathology.
    Matched MeSH terms: Aged; Middle Aged
  4. Recurrent laryngeal nerve in thyroid surgery: a critical appraisal
    Hisham AN, Lukman MR
    ANZ J Surg, 2002 Dec;72(12):887-9.
    PMID: 12485227 DOI: 10.1046/j.1445-2197.2002.02578.x
    BACKGROUND: Identification and preservation of the recurrent laryngeal nerve (RLN) is of major concern in surgery of the thyroid gland. The purpose of this study was to review the surgical anatomy of the nerve and to describe its relationship to other important structures.
    METHODS: A total of 325 patients were accrued in this prospective non-randomized study from January 1999 to December 2000. All patients who had total, subtotal and hemithyroidectomies were included in this study. Each side of the thyroid gland was considered as a separate unit in the analysis of the results.
    RESULTS: Two hundred and seventy-six patients had thyroidectomies as their primary operation, while 49 patients had them as a reoperative procedure. There were 276 women and 46 men (6:1 female to male ratio) with a mean age of 43.1 years (range: 10-84 years). The total number of dissections was 502. The RLN was clearly identified in 491 (97.8%) dissections: single trunk in 323 dissections (65.8%), two extralaryngeal branches in 164 dissections (33.4%), and three extralaryngeal branches in three dissections (0.6%). One non-recurrent laryngeal nerve was encountered (0.2%) in the series. The proximity of the RLN to the inferior thyroid artery (ITA) was noted in 444 (90.4%) dissections: 372 (83.8%) nerves were described to be posterior and intertwined between the branches of the ITA, and in 72 (16.2%) RLNs, they were observed to be anterior to the ITA. The close association of RLN to an enlarged tubercle of Zuckerkandl was documented in 381 dissections (73.7%). A total of 231 RLNs (60.8%) was seen in the tracheoesophageal groove, 18 (4.9%) nerves were observed to be lateral to the trachea, and in 109 (28.3%), they were posterior in location. Of concern in 23 (6.0%) dissections the RLN was on the anterior surface of the thyroid gland, which is at highest risk of injury before curving down to pass behind the tubercle of Zuckerkandl. It appears that the anterior course of the RLN was seen more often in the reoperative procedures to the thyroid gland (20%).
    CONCLUSIONS: Although various methods of localizing the RLN have been described, surgeons should be aware of the variations and have a thorough knowledge of normal anatomy in order to achieve a high standard of care. This will ensure the integrity and safety of the RLN in thyroid surgery. The anatomical variation may be minor in degree, but is of great importance as it may affect the outcome of the surgery and the patient's quality of life.
    Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged
  5. Thyroid cancer: The Kuala Lumpur experience
    Abdullah M
    ANZ J Surg, 2002 Sep;72(9):660-4.
    PMID: 12269919
    There have been few detailed studies on thyroid cancer (TC) in Malaysia, a multiethnic country with three major races - Malays, Chinese and Indians.
    Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged
  6. Epidemiology of abdominal aortic aneurysm in an Asian population
    Yii MK
    ANZ J Surg, 2003 Jun;73(6):393-5.
    PMID: 12801335
    Abdominal aortic aneurysms (AAA) are common in the Caucasian population. Apart from reported differences in the occurrence of AAA in the black and white populations, there are few studies on the incidence of AAA in the Asian population.
    Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged
  7. Ductal carcinoma in situ of the breast in Singapore: recent trends and clinical implications
    Tan KB, Lee HY, Putti TC
    ANZ J Surg, 2002 Nov;72(11):793-7.
    PMID: 12437689
    Breast ductal carcinoma in-situ (DCIS) is increasingly being diagnosed as a result of screening mammography and better pathological recognition. With this and the rising breast cancer incidence in Singapore, DCIS is poised to become a bigger part of surgical practice. Principles of screening, diagnosis and management of DCIS have also been rapidly evolving. Against this background, a clinicopathological audit of recent cases of DCIS in our centre was performed.
    Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged
  8. A reappraisal of thyroid surgery under local anaesthesia: back to the future?
    Hisham AN, Aina EN
    ANZ J Surg, 2002 Apr;72(4):287-9.
    PMID: 11982518 DOI: 10.1046/j.1445-2197.2002.02372.x
    BACKGROUND: Thyroid surgery is usually performed under general anaesthesia. However, for a selected group of patients, local anaesthesia may be preferable. The aim of this study was to review the authors' experiences with local anaesthesia with regard to the safety and outcome of this approach.
    METHODS: A total of 65 consecutive patients who underwent primary thyroid surgery were accrued prospectively into this study from May to December 1999. A field block with 0.5% bupivacaine and adrenaline in 1:200 000 dilutions was given in all cases. In addition, light sedative and narcotics were given as necessary to achieve patient comfort and cooperation. The pain experienced during surgery was recorded using a visual analogue scoring system on a scale of 1-10.
    RESULTS: Unilateral thyroid resection was performed in 58 patients, isthmectomy in four patients and bilateral thyroid resection in three patients, two of which were in their second trimester of pregnancy diagnosed with papillary thyroid cancer. There were 55 women and 10 men with an average age of 38.2 years (range: 18-67 years). No conversion to general anaesthetic was needed, and the mean operating time was 80 min. The postoperative recovery was quick with this technique and, of interest, 22 (33.9%) patients were discharged within 6 h following the surgery. Overall 62 (95.4%) patients were discharged in the first 24 h and three (4.6%) patients after 24 h. There were no significant postoperative complications encountered except for wound infection in two (3.1%) patients.
    CONCLUSIONS: Thyroid surgery under local anaesthesia can be performed safely in a selected group of patients. It offers an effective alternative approach to general anaesthesia and is associated with low morbidity and high levels of patient satisfaction.
    Matched MeSH terms: Aged; Middle Aged
  9. Comparison of post-operative pain in short versus long stitch technique for abdominal wall closure after elective laparotomy: a double-blind randomized controlled trial
    Lai LW, Roslani AC, Yan YW, Bhojwani KM, Jamaluddin MFH
    ANZ J Surg, 2021 05;91(5):896-901.
    PMID: 33522667 DOI: 10.1111/ans.16567
    BACKGROUND: Conventional mass closure uses suture-to-wound length ratio of 4:1 ('long stitch', LS). 'Short stitch' (SS) has a suture-to-wound length ratio of more than 4 and incorporates only the linea alba, which may reduce tension and pain. We compared the post-operative pain after laparotomy closure using LS and SS.

    METHODS: Patients undergoing elective midline laparotomy through standardized incisions in two tertiary hospitals from February 2017 to September 2018 were randomized to either LS or SS. The primary outcome was post-operative patient-controlled analgesia morphine usage at 24 h. Secondary outcomes were presence of surgical site infection and length of hospital stay (LOHS). Categorical variables were analysed using chi-squared analysis. Outcomes of study were tested for normal distribution. Skewed data were analysed using Mann-Whitney U-test.

    RESULTS: Eighty-six patients were recruited (42 SS and 44 LS). The median age was 66 (interquartile range (IQR) 15). Majority were males (62.8%) and Chinese (50%). The median incision length was 17 cm in both groups. The median patient-controlled analgesia morphine usage 24 h post-operatively did not differ significantly (SS 21 mg, IQR 28.3; LS 18.5 mg, IQR 33.8, P = 0.829). The median pain score at rest (SS 1, IQR 1; LS 1, IQR 2, P = 0.426) and movement (SS 3, IQR 1; LS 3, IQR 2, P = 0.307) did not differ significantly. LOHS was shorter in the SS group (SS 6, IQR 4; LS 8, IQR 5, P = 0.034). The rate of surgical site infection trended lower in the SS group with no statistical difference.

    CONCLUSION: There were no differences in post-operative pain between SS and LS but we found that there were shorter LOHS in SS arm as secondary outcome.

    Matched MeSH terms: Aged
  10. Dermatofibrosarcoma protuberans of the scalp: therapeutic challenges
    Kanesen D, Zakaria Z, Ch'ng ES, Nandrajog P, Kandasamy R
    ANZ J Surg, 2019 03;89(3):261-264.
    PMID: 28513108 DOI: 10.1111/ans.14040
    Matched MeSH terms: Middle Aged
  11. Clinical and radiological profile of symptomatic knee osteoarthritis in Malaysia
    Veerapen K, Asokan RN, Rathakrishnan V
    APLAR Journal of Rheumatology, 2004;7(2):97-107.
    DOI: 10.1111/j.1479-8077.2004.00069.x
    Aims: To create a clinical and radiological profile of patients with symptomatic osteoarthritis of the knee in Malaysia.
    Methods: One hundred consecutive patients presenting with symptomatic knee osteoarthritis at a private rheumatology clinic were profiled for demographic and clinical features. Anteroposterior weight-bearing, skyline and lateral knee X-rays were taken. Statistical Package for Social Sciences was used for data analysis.
    Results: Women predominated (93%). Fifty-eight percent of the patients reported bilateral knee pain. Difficulty in walking, climbing and squatting was high (85%, 97% and 93% respectively). Patients with knee pain had a higher BMI than controls. Radiological abnormality, related to osteoarthritis was present in 97%. Osteophytes were generally tricompartmental while joint space narrowing was less evident in the lateral tibiofemoral joint than in the medial tibiofemoral joint and the patellofemoral joint. Almost half (49%) the patients manifested radiological varus deformity The severity of radiological abnormality increased with age. Although patients with unilateral pain had milder radiological abnormality, it tended to be bilateral. Clinically detectable hip abnormality and nodal osteoarthritis were uncommon, as was radiological chondrocalcinosis.
    Conclusions: Patients presenting with symptomatic knee osteoarthritis to a rheumatology service had a high degree of disability, radiological abnormality and varus deformity. Radiological abnormalities were essentially bilateral and tricompartmental. © Asia Pacific League of Associations for Rheumatology.
    Matched MeSH terms: Aged
  12. Risk of hospitalization for upper gastrointestinal tract complications associated with non-selective non-steroidal anti-inflammatory drugs in Malaysia: A retrospective case control study
    Ong JSK, Menon SK, Kew ST, Menon J, Mavros P, Thong SP, et al.
    APLAR Journal of Rheumatology, 2004;7(3):196-203.
    DOI: 10.1111/j.1479-8077.2004.00094.x
    Aims: To assess the association between non-steroidal anti-inflammatory drug (NSAID) use and upper gastrointestinal (GI) tract-related hospitalizations and to evaluate inpatient healthcare resource utilization associated with these complications in Malaysia.
    Methods: A retrospective case control study was performed using medical records of patients admitted to two Malaysian hospitals during 1999 and 2000. Cases were identified based on mode of presentation at hospital admission. One control was identified for each case, matched by age, sex and admission date. NSAID exposure was determined by drug use during one year prior to admission. Conditional logistic regression analysis was used to determine the association between NSAID use and upper GI complications, adjusting for predictors.
    Results: The 273 cases were significantly more likely to have used NSAIDs in the year prior to hospitalization than controls (27.8% vs. 6.2% of patients; P < 0.0001). Conditional logistic regression analysis adjusting for other predictors showed that the odds of being hospitalized for upper GI tract complications were 4.1 times higher among NSAID users than non-users (95% CI = 1.88-9.12). Other risk factors for GI-related hospitalizations were a history of upper GI tract complications (OR = 5.8, 95% CI = 1.28-26.53), use of gastroprotective agents (OR = 5.3, 95% CI = 1.67-16.79), and use of antacids (OR = 5.0, 95% CI = 2.10-11.91) in the previous year.
    Conclusion: This study demonstrated that NSAID exposure was significantly higher among patients hospitalized for GI-related complications than for other reasons, indicating that NSAID use is an independent risk factor for upper GI tract complications in this Malaysian sample.
    Matched MeSH terms: Aged
  13. Fulltext The incidence of hip fracture in Malaysians above 50 years of age: Variation in different ethnic groups
    Lee JK, Amir Sharifuddin MK
    APLAR Journal of Rheumatology, 2007;10:300-305.
    DOI: 10.1111/j.1479-8077.2007.00314.x
    Aims: Hip fracture is frequently studied to reflect osteoporosis related fractures. The aim of this study was to look at ethnic differences in the incidence of hip fractures between the three races in Malaysia. Methods: This was a retrospective study performed for the years 1996 and 1997. Data from hospitals treating hip fractures in elderly patients were collected throughout the whole country. Result: The overall incidence of hip fractures was 90 per 100 000 individuals. Sixty-three percent of patients presenting with hip fractures were Chinese. This was followed by Malays at 20% and Indians, 13%. Race-specific incidence data showed that the fracture rates are highest among the Chinese (160 per 100 000) followed by Indians (150 per 100 000) and Malays (30 per 100 000). Females were twice as commonly affected compared to males. Race and sex-specific incidence data showed that the incidence was highest among Chinese females (220 per 100 000), followed by Indian females (200 per 100 000). The age-specific incidence was 500 per 100 000 for patients above 75 years, compared to 10 per 100 000 in those between 50 and 54 years. Conclusion: Hip fractures arecommon in Malaysia. There are differences in hip fracture incidence depending upon ethnicity. © 2007 Asia Pacific League of Associations for Rheumatology.
    Matched MeSH terms: Aged
  14. Molecular alterations of Ras-Raf-mitogen-activated protein kinase and phosphatidylinositol 3-kinase-Akt signaling pathways in colorectal cancers from a tertiary hospital at Kuala Lumpur, Malaysia
    Yip WK, Choo CW, Leong VC, Leong PP, Jabar MF, Seow HF
    APMIS, 2013 Oct;121(10):954-66.
    PMID: 23992303 DOI: 10.1111/apm.12152
    Molecular alterations in KRAS, BRAF, PIK3CA, and PTEN have been implicated in designing targeted therapy for colorectal cancer (CRC). The present study aimed to determine the status of these molecular alterations in Malaysian CRCs as such data are not available in the literature. We investigated the mutations of KRAS, BRAF, and PTEN, the gene amplification of PIK3CA, and the protein expression of PTEN and phosphatidylinositol 3-kinase (PI3K) catalytic subunit (p110α) by direct DNA sequencing, quantitative real-time PCR, and immunohistochemistry, respectively, in 49 CRC samples. The frequency of KRAS (codons 12, 13, and 61), BRAF (V600E), and PTEN mutations, and PIK3CA amplification was 25.0% (11/44), 2.3% (1/43), 0.0% (0/43), and 76.7% (33/43), respectively. Immunohistochemical staining demonstrated loss of PTEN protein in 54.5% (24/44) of CRCs and no significant difference in PI3K p110α expression between CRCs and the adjacent normal colonic mucosa (p = 0.380). PIK3CA amplification was not associated with PI3K p110α expression level, but associated with male cases (100% of male cases vs 56% of female cases harbored amplified PIK3CA, p = 0.002). PI3K p110α expression was significantly higher (p = 0.041) in poorly/moderately differentiated carcinoma compared with well-differentiated carcinoma. KRAS mutation, PIK3CA amplification, PTEN loss, and PI3K p110α expression did not correlate with Akt phosphorylation or Ki-67 expression. KRAS mutation, PIK3CA amplification, and PTEN loss were not mutually exclusive. This is the first report on CRC in Malaysia showing comparable frequency of KRAS mutation and PTEN loss, lower BRAF mutation rate, higher PIK3CA amplification frequency, and rare PTEN mutation, as compared with published reports.
    Matched MeSH terms: Aged; Middle Aged
  15. Genetic polymorphisms of TP53-binding protein 1 (TP53BP1) gene and association with breast cancer risk
    Naidu R, Har YC, Taib NA
    APMIS, 2011 Jul;119(7):460-7.
    PMID: 21635553 DOI: 10.1111/j.1600-0463.2011.02753.x
    In the present study, we evaluated the association between the TP53BP1 Glu353Asp and T-885G polymorphisms and breast cancer risk as well as with the clinicopathological characteristics of the patients. Genotyping of these polymorphisms was performed on 387 breast cancer patients and 252 normal and healthy women who had no history of any malignancy using PCR-RFLP method in a hospital-based Malaysian population. Breast cancer risk was not observed among women who were heterozygous (OR(adj) = 0.887; 95% CI, 0.632-1.245) or homozygous (OR(adj) = 1.083; 95% CI, 0.595-1.969) for Asp allele, and those carriers of Asp allele (OR(adj) = 0.979; 95% CI, 0.771-1.243). Similarly, women who were TG heterozygotes (OR(adj) = 1.181; 95% CI, 0.842-1.658) or GG homozygotes (OR(adj) = 1.362; 95% CI, 0.746-2.486) and carriers of G allele (OR(adj) = 1.147; 95% CI, 0.903-1.458) were not associated with increased risk of breast cancer. Asp allele genotype was significantly associated with ER negativity (p = 0.0015) and poorly differentiated tumours (p = 0.008), but G allele genotype was not associated with the clinicopathological characteristics. In conclusion, Glu353Asp and T-885G polymorphic variants might not have an influence on breast cancer risk, thus might not be potential candidates for cancer susceptibility. Glu353Asp variant might be associated with tumour aggressiveness as defined by its association with ER negativity and poorly differentiated tumours.
    Matched MeSH terms: Aged; Middle Aged
  16. Fulltext Stress and coping strategies among retired people in Malaysia: a qualitative study
    Al-Naggar, Redhwan Ahmed, Chen, Robert
    ASEAN Journal of Psychiatry, 2011;12(2):0-0.
    MyJurnal
    Objective: This study explored the stress and coping strategies among retired people in Malaysia. Methods: In-depth interviews were conducted with 36 elderly Malaysian subjects. This protocol was approved by the Ethics Committee of the Management and Science University. The data obtained were sorted into various categories. Results: A total number of 36 retired elderly people participated in this study. The majority of them were in the age group of 55-59 years old, females, Malay and married. The majority defined stress as pressure or tension. Financial difficulties, family and work problems were the main causes of stress in the majority. Also, the majority of respondents mentioned that they coped with stress by sharing problems with others, by resting and relaxing, and/or by doing housework during their free time. A few of them coped with stress by hanging out with friends, going shopping,
    doing photography, travelling, going fishing, and doing sports. Conclusion: Financial difficulties, family and work problems were the main causes of stress among elderly people. They coped with stress by sharing problems with others, resting and relaxing, and/or doing housework during their free time.
    Matched MeSH terms: Aged
  17. Fulltext Dementia in Malaysia: issues and challenges
    Nikmat AW, Hawthorne G, Al-Mashoor SHA
    ASEAN Journal of Psychiatry, 2011;12(1):95-101.
    MyJurnal
    Objective: The number of people surviving until old age has been increasing worldwide. Reductions in both fertility and mortality rates, better living standards, nutrition and health care are claimed to be the key factors that increase the proportion of aged people within the population. Nevertheless, growing numbers of older adults also increases the susceptibility to diseases that commonly afflict the elderly, such as dementia. In this article, we discuss on the current issues of dementia in Malaysia and its challenge in providing a
    better management and services for this population. Methods and Results:Review of literature by searching the databases CINAHL, SCOPUS, MEDLINE and PsychINFO from June 2010 to November 2010 was done on the issues involving dementia patients in Malaysia such as ageing trend, awareness and availability of services. Conclusion: Despite a limited number of studies on dementia in Malaysia, literature revealed the importance of
    acknowledging the issues and improving the services for the patients. Efforts should be made by the government and private sectors to promote healthy ageing in Malaysia.
    Matched MeSH terms: Aged
  18. Fulltext Personality profile among hypertensive patient undergoing pharmacological treatment in primary care setting
    Azlin Baharudin, Hatta Sidi, Norzila Zakaria, Sharifah Ezat Wan Puteh
    ASEAN Journal of Psychiatry, 2007;8(2):51-63.
    MyJurnal
    Objective: This study aimed to determine the association between the personality traits and
    social factors with compliance to anti-hypertensive pharmachotherapy. Methods: This cross
    sectional study was conducted from 1st of June until 31st of December 2004, which involved
    Hospital Universiti Kebangsaan Malaysia Primary Polyclinic in Bandar Tasik Selatan,
    Cheras and Salak Polyclinic in Sepang, Selangor. A total of 200 patients who fulfilled all the inclusion criteria, were selected as respondents. This study used the Mini International Neuropsychiatric Interview (M.I.N.I) for the psychiatric diagnoses and personality characteristics were assessed by using Personality Assessment Schedule (PAS) Results: The prevalence rate of non-compliance was 38.5%. Paranoid personality trait (27.3%) was the most common type of personality traits that associated with non-compliance to the medications prescribed. The results of this study revealed a statistically significant difference between drug compliance and age, race, gender and the site where the study was conducted. No association was found between patients’ education level, occupation, income, marital status, family history of hypertension and personality traits and drug compliance. Conclusion: This study suggested that drug compliance among hypertensive patients was influenced by the presence of psychosocial factors. Hence, it is important for medical practitioners to understand these factors and administer treatment more individual.
    Matched MeSH terms: Aged
  19. Fulltext Sexual desire and sexual arousal in Malaysian women: are they of the same entity?
    Nik Jaafar NR, Midin M, Wan Puteh SE, Musa R
    ASEAN Journal of Psychiatry, 2009;10(1):43-53.
    MyJurnal
    Objective: To investigate the correlation between sexual desire and sexual arousal among Malaysian women in a primary care setting. Methods: The Malay Version of Female Sexual Function Index (MVFSI) was used to assess low sexual desire and lack of sexual arousal among the respondents. A total of 230 married women aged 18 – 70 years old participated in this study. Their sociodemographic, marital profiles and correlation between low sexual desire and lack of sexual arousal were examined. Results: More than 60% respondents with low sexual desire have co-exist low sexual arousal and 94.4% respondents with high sexual desire do have high sexual arousal ( χ²= 79.6, p
    Matched MeSH terms: Aged
  20. Fulltext Older adults with cognitive impairment living in Malaysian nursing homes - have we met their needs?
    Azlina Wati Nikmat, Syed Hassan Almashoor
    ASEAN Journal of Psychiatry, 2015;16(1):84-94.
    MyJurnal
    Objective: Transition of people with cognitive impairment to nursing home is often an option when their disease progresses and their needs become too complex. The aim of this study was to identify the needs of people with cognitive impairment living in nursing homes and factors associated with higher level of needs.
    Methods: A cross sectional survey involving 110 respondents with cognitive impairment aged ≥60 was carried out. Respondents were assessed using the Short Mini Mental State Examination (SMMSE), Camberwell Assessment of Needs for Elderly (CANE), Barthel Index (BI), Friendship Scale (FS), and Geriatric Depression Scale (GDS).
    Results: Respondents with cognitive impairment had a mean of 2.81 (SD=3.72) for unmet needs and 11.95 (SD=3.14) for the met needs, with higher mean suggesting a better outcome measure. The most frequent unmet needs were intimate relationships (66.40%), company (40.00%), and daytime activity (34.50%). Unmet needs were significantly associated with depression, social isolation, and cognitive impairment.
    Conclusion: Most of the needs of people with cognitive impairment in nursing homes were fulfilled, except in social area. Therefore, attention should be given in improving the care system, which emphasizes collaboration between people with cognitive impairment, family members, community, and government in helping to reduce the risk of loneliness in those with cognitive impairment.
    Matched MeSH terms: Aged
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