Displaying publications 41 - 55 of 55 in total

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  1. Yusof MI, Sulaiman AR, Muslim DA
    Singapore Med J, 2007 Aug;48(8):729-32.
    PMID: 17657379
    INTRODUCTION:
    Many conditions, including benign and malignant tumours, peripheral vascular diseases and open fracture grade 3C, have been successfully treated with limb sparing procedures. However, the same could not be said for treatment of limb infection, especially late stage diabetic foot complications.

    METHODS:
    This is a retrospective review of patients who underwent operations at our hospital from July 2003 to June 2005. All patients who underwent various types of limbs amputations were included. The cohort was divided according to the diagnosis leading to the amputation and the level of amputation. The number and levels of amputation were then compared with the various causes leading to the amputation.

    RESULTS:
    There were 203 patients who underwent amputation during the period of study. 135 (66.5 percent) of the patients were diabetic and amputations performed were related to diabetic foot conditions. 68 (33.5 percent) patients were not known to have diabetes mellitus. Among nondiabetic patients, 54 (26.6 percent) amputations were due to trauma, 11 (5.4 percent) were related to musculoskeletal tumours and 3 (1.5 percent) were due to peripheral vascular disease. Among diabetic patients, 23 (17 percent) patients underwent above knee amputation, 44 (33 percent) patients underwent below knee amputation, and 68 (50 percent) patients underwent local foot amputation. 80 of 135 (59.3 percent) patients, who underwent amputation due to diabetic complications, were less than 60 years old.

    CONCLUSION:
    Good diabetic control and detection of early diabetic foot complications will reduce the number of patients undergoing limb amputation as well as the number of amputees. Since the incidence of lower limb amputation is due mainly to poor diabetic control, it is important to protect this group of patients from a probable avoidable amputation.
    Matched MeSH terms: Peripheral Vascular Diseases/surgery
  2. Biccard BM, Sigamani A, Chan MTV, Sessler DI, Kurz A, Tittley JG, et al.
    Br J Surg, 2018 11;105(12):1591-1597.
    PMID: 30019751 DOI: 10.1002/bjs.10925
    BACKGROUND: In the POISE-2 (PeriOperative ISchemic Evaluation 2) trial, perioperative aspirin did not reduce cardiovascular events, but increased major bleeding. There remains uncertainty regarding the effect of perioperative aspirin in patients undergoing vascular surgery. The aim of this substudy was to determine whether there is a subgroup effect of initiating or continuing aspirin in patients undergoing vascular surgery.

    METHODS: POISE-2 was a blinded, randomized trial of patients having non-cardiac surgery. Patients were assigned to perioperative aspirin or placebo. The primary outcome was a composite of death or myocardial infarction at 30 days. Secondary outcomes included: vascular occlusive complications (a composite of amputation and peripheral arterial thrombosis) and major or life-threatening bleeding.

    RESULTS: Of 10 010 patients in POISE-2, 603 underwent vascular surgery, 319 in the continuation and 284 in the initiation stratum. Some 272 patients had vascular surgery for occlusive disease and 265 had aneurysm surgery. The primary outcome occurred in 13·7 per cent of patients having aneurysm repair allocated to aspirin and 9·0 per cent who had placebo (hazard ratio (HR) 1·48, 95 per cent c.i. 0·71 to 3·09). Among patients who had surgery for occlusive vascular disease, 15·8 per cent allocated to aspirin and 13·6 per cent on placebo had the primary outcome (HR 1·16, 0·62 to 2·17). There was no interaction with the primary outcome for type of surgery (P = 0·294) or aspirin stratum (P = 0·623). There was no interaction for vascular occlusive complications (P = 0·413) or bleeding (P = 0·900) for vascular compared with non-vascular surgery.

    CONCLUSION: This study suggests that the overall POISE-2 results apply to vascular surgery. Perioperative withdrawal of chronic aspirin therapy did not increase cardiovascular or vascular occlusive complications. Registration number: NCT01082874 ( http://www.clinicaltrials.gov).

    Matched MeSH terms: Vascular Diseases/etiology; Vascular Diseases/mortality
  3. Si LY, Kamisah Y, Ramalingam A, Lim YC, Budin SB, Zainalabidin S
    Appl Physiol Nutr Metab, 2017 Jul;42(7):765-772.
    PMID: 28249121 DOI: 10.1139/apnm-2016-0506
    Vascular endothelial dysfunction (VED) plays an important role in the initiation of cardiovascular diseases. Roselle, enriched with antioxidants, demonstrates high potential in alleviating hypertension. This study was undertaken to investigate the effects of roselle supplementation of VED and remodelling in a rodent model with prolonged nicotine administration. Male Sprague-Dawley rats (n = 6 per group) were administered with 0.6 mg/kg nicotine for 28 days to induce VED. The rats were given either aqueous roselle (100 mg/kg) or normal saline orally 30 min prior to nicotine injection daily. One additional group of rats served as control. Thoracic aorta was isolated from rats to measure vascular reactivity, vascular remodelling and oxidative stress. Roselle significantly lowered aortic sensitivity to phenylephrine-induced vasoconstriction (Endo-(+) Cmax = 234.5 ± 3.9%, Endo-(-) Cmax = 247.6 ± 5.2%) compared with untreated nicotine group (Endo-(+) Cmax = 264.5 ± 6.9%, Endo-(-) Cmax = 276.5 ± 6.8%). Roselle also improved aortic response to endothelium-dependent vasodilator, acetylcholine (Endo-(+) Rmax = 73.2 ± 2.1%, Endo-(-) Rmax = 26.2 ± 0.8%) compared to nicotine group (Endo-(+) Rmax = 57.8 ± 1.7%, Endo-(-) Rmax = 20.9 ± 0.8%). In addition, roselle prevented an increase in intimal media thickness and elastic lamellae proliferation to preserve vascular architecture. Moreover, we also observed a significantly lowered degree of oxidative stress in parallel with increased antioxidant enzymes in aortic tissues of the roselle-treated group. This study demonstrated that roselle prevents VED and remodelling, and as such it has high nutraceutical value as supplement to prevent cardiovascular diseases.
    Matched MeSH terms: Vascular Diseases/chemically induced; Vascular Diseases/prevention & control*
  4. Rahman S, Ismail AA, Ismail SB, Naing NN, Abdul Rahman AR
    Eur J Clin Pharmacol, 2007 Aug;63(8):733-41.
    PMID: 17565489 DOI: 10.1007/s00228-007-0315-3
    OBJECTIVE: To investigate whether pharmacological interventions with rosiglitazone/ramipril can reverse preclinical vasculopathy in newly diagnosed untreated patients with type 2 diabetes (T2DM) and impaired glucose tolerance (IGT).

    METHODS: In this randomised, double-blind, placebo-controlled study, 33 T2DM and 33 IGT patients were randomised to 4 mg rosiglitazone or 5 mg ramipril or placebo for 1 year. The subjects were newly diagnosed, untreated, normotensive, nonobese, nonsmoker, and nonhyperlipidaemic. Haemodynamic variables were measured at three treatment phases and pulse wave velocity (PWV) and augmentation index (AI) were measured throughout the treatment period.

    RESULTS: Rosiglitazone showed a significant reduction in PWV (p=0.039) and AI (p=0.031) and ramipril demonstrated a significant reduction of AI (p=0.025) in IGT in comparison to placebo on the 12th month of treatment. No significant difference was observed in PWV and AI in T2DM with rosiglitazone/ramipril in comparison to placebo during overall treatment period.

    CONCLUSIONS: Rosiglitazone significantly reversed preclinical vasculopathy in IGT as evident by significant decrease in PWV and AI after 1 year of treatment. Ramipril also reduced large artery stiffness as shown by significant decrease of AI after 1 year of treatment in IGT. Further trials are needed for a longer period of time, maybe with higher doses, to show whether rosiglitazone/ramipril can reverse preclinical vasculopathy in T2DM.
    Matched MeSH terms: Vascular Diseases/drug therapy*; Vascular Diseases/etiology
  5. Ishak R, Hassan K, Arshat H
    Malays J Reprod Health, 1987 Dec;5(2):57-60.
    PMID: 12315184
    Matched MeSH terms: Vascular Diseases*
  6. Fernandez AR, Husain R
    J Obstet Gynaecol Res, 2015 Feb;41(2):277-82.
    PMID: 25255906 DOI: 10.1111/jog.12511
    During preeclampsia (PE), the excessive circulation of soluble fms-like tyrosine kinase 1 (sFLT1) hinders the vasodilatory effect of vascular endothelial growth factor (VEGF). This effect has been proven in vitro in the renal artery of rats. The endothelium of the blood vessels is also said to be dysfunctional in PE. Genistein has shown the ability to antagonize the vascular contractions caused by a wide range of contractile agents. We conducted vascular reactivity studies to demonstrate the effect of: (i) sFLT1 on the vasodilatory effect of VEGF; and (ii) genistein on the vasodilatory effect of VEGF and its effects on denuded blood vessels (dysfunctional endothelium).
    Matched MeSH terms: Vascular Diseases
  7. Osman A, Khalid BA
    Asia Pac J Clin Nutr, 1994 Mar;3(1):33-9.
    PMID: 24351204
    There is an increasing prevalence of diabetes mellitus around the world associated with rapid sociocultural development and changing lifestyles. Increased prevalence of obesity, with a higher consumption of animal products and lower consumption of fruits and vegetables, increases the risk of diabetes mellitus and other chronic degenerative diseases. Insulin-dependent diabetes (IDD) is caused by insulin deficiency, whereas the main feature of non-insulin-dependent diabetes (NIDD) which accounts for more than 90% of diabetics, is hyperinsulinemia and insulin resistance, which may eventually lead to actual insulin deficiency. Hyperinsulinemia is undesirable because it increases the risk of developing vascular disease. In Malaysia, the prevalence of NIDD in some communities now exceeds 5%, and of impaired glucose tolerance 10%. Along with these increases in prevalence of hyperglycemia are increases in prevalence of overweight (BMI>25) and almost certainly abdominal fatness. In terms of management, nutrition is given priority. Insulin and hypoglycemic drugs (sulphonylureas or biguanides), where required, may adversely affect body composition if overused. Newer therapeutic strategies require greater attention to the underlying problem in NIDD of abdominal fatness by attention to the relevant nutritional factors, physical activity and other lifestyle factors like cigarette smoking and alcohol. The greater impact of obesity and diabetes on Malaysian women as opposed to men also needs to be addressed.
    Matched MeSH terms: Vascular Diseases
  8. Malaysia. High Court
    Annu Rev Popul Law, 1987;14:39.
    PMID: 12346715
    The defendant, an obstetrician and gynaecologist, was accused of voluntarily causing a woman to miscarry, such miscarriage having been performed without good faith and an intention to save the woman's life. The Court upheld the conviction of the defendant, rejecting his argument, supported by an expert witness, that he had performed the abortion in order to avoid the possibility of pulmonary embolism, which might result because the woman had enlarged varicose veins. It held that the argument was not reasonable under the current law and that procuring an abortion was a serious matter to be done only as a last resort to save the life of a woman or to save her from becoming a mental "wreck."
    Matched MeSH terms: Vascular Diseases
  9. Irfan M, Ismail SB, Noor NM, Hussain NHN
    Am J Mens Health, 2020 10 29;14(5):1557988320969082.
    PMID: 33111628 DOI: 10.1177/1557988320969082
    One of the major causes of erectile dysfunction (ED) is an endothelial vascular disorder. This meta-analysis is performed to determine the efficacy of aspirin on erectile function in men with vasculogenic ED. For this purpose, CENTRAL, MEDLINE, and reference lists of articles up to November 2019 were searched. Randomized controlled trials (RCTs) were selected that compared aspirin with placebo in men of any ethnicity with vasculogenic ED. A total of 58 trials were retrieved. Finally, two trials of 214 men fulfilled our selection criteria. High selection and detection bias were identified for one trial. The participants showed a significant improvement in erectile function when they took aspirin (mean difference: 5.14, 95% CI [3.89, 6.40], and I2 = 0%). Although the present meta-analysis suggested that aspirin has a significant effect on the improvement of erectile function, there were limited RCTs available on this topic and doses of aspirin varied. Additional studies are needed to support findings from this meta-analysis. Aspirin needs to be considered by practitioners when prescribing drugs for vasculogenic ED.
    Matched MeSH terms: Vascular Diseases
  10. Khatoon R, Khoo EM
    Asia Pac Fam Med, 2007;6(1).
    Aims: To determine whether the Edinburgh Claudication Questionnaire (ECQ) can be used as a screening tool for detecting peripheral arterial disease in patients with diabetes mellitus. 
    Methods: A cross-sectional study of 200 patients with diabetes over 18 years of age who attended a primary care clinic at a teaching hospital in Kuala Lumpur, Malaysia. Face-to-face interviews were conducted using the ECQ for the presence of intermittent claudication. Blood pressure and peripheral neuropathy were assessed. Ankle brachial pressure index (ABPI) was measured and used as a gold standard for the diagnosis of eripheral arterial disease (PAD), which was defined as an ABPI of < 0.9 on either leg. 
    Results: The overall prevalence of PAD was found to be 16% among patients with diabetes based on ABPI. Among these 32 patients with PAD, eight (25%) had symptoms of intermittent claudication based on the ECQ. The ECQ was found to have a low sensitivity (25%) but a high specificity (99.4%), with a positive predictive value of 88.9% and a negative predictive value of 88% for diagnosing PAD in patients with diabetes. 
    Conclusions: The ECQ is not a good screening tool for detection of PAD among patients with diabetes due to its low sensitivity. Key words: ankle brachial pressure, diabetes mellitus, Edinburgh Claudication Questionnaires, intermittent claudication, peripheral arterial disease.
    Matched MeSH terms: Peripheral Vascular Diseases
  11. Leong XF, Rais Mustafa M, Jaarin K
    PMID: 23533459 DOI: 10.1155/2013/120732
    Hypertension increases the risk for a variety of cardiovascular diseases, including stroke, coronary artery disease, heart failure, and peripheral vascular disease. The increase in oxidative stress has been associated with the pathogenesis of hypertension. Increase of blood pressure is due to an imbalance between antioxidants defence mechanisms and free radical productions. Excessive production of reactive oxygen species reduces nitric oxide bioavailability leading to an endothelial dysfunction and a subsequent increase in total peripheral resistance. Hypertension can cause few symptoms until it reaches the advanced stage and poses serious health problems with lifelong consequences. Hypertensive patients are required to take drugs for life to control the hypertension and prevent complications. Some of these drugs are expensive and may have adverse reactions. Hence, it is timely to examine scientifically, complimentary therapies that are more effective and with minimal undesirable effects. Nigella sativa (NS) and its active constituents have been documented to exhibit antioxidant, hypotensive, calcium channel blockade and diuretic properties which may contribute to reduce blood pressure. This suggests a potential role of NS in the management of hypertension, and thus more studies should be conducted to evaluate its effectiveness.
    Matched MeSH terms: Peripheral Vascular Diseases
  12. Ishak R, Mohamed AB, Hassan K
    Malays J Reprod Health, 1990 Jun;8(1):1-4.
    PMID: 12316339
    A study was conducted on a total of 100 women attending the Family Planning Clinic in Kuala Lumpur. 50 took combined low-dose estrogen and progesterone pills for a year or more and the other 50 used different methods of birth control. Platelet aggregation, ATP release, Thromboxane B2, and 6-keto-prostaglandin F1alpha estimations were made to evaluate the effect of oral contraceptives (OCs) on platelet function and prostanoid production. The results showed no significant differences in the parameters measured in the 2 groups investigated. These findings are comparable to those reported by other studies, suggesting relatively low risk, if any, of thrombosis in OC users.
    Matched MeSH terms: Vascular Diseases
  13. Wong KK, Ng SC, Koong PL
    Med Sci Res, 1992 Jun;20(12):439-40.
    PMID: 12288974
    Matched MeSH terms: Vascular Diseases
  14. Ishak R, Loh Chooi Khim
    Malays J Reprod Health, 1991 Jun;9(1):5-8.
    PMID: 12317443
    Matched MeSH terms: Vascular Diseases
  15. Ishak R, Ahmad R, Gudum HR, Hassan K, Ang ES
    Malays J Reprod Health, 1992 Jun;10(1):7-11.
    PMID: 12345026
    PIP: Long term use of low doses of combination oral contraceptives appears to increase plasminogen level, thereby increasing fibrinolytic activity and reducing the risk of thromboembolism. Blood levels of plasminogen, tissue plasminogen activator (tPA), and plasminogen activator inhibitor (PAI), were measured before and after stress (5 minutes of stair climbing) in a group of 30 women, 23-40 years old, who had taken 30 mcg of ethinyl estradiol with 150 mcg of desogestrel or levonorgestrel for at least 1 year. Similar measurements were taken from a control group of 30 women matched for age, height, and weight. Plasminogen and tPA levels in both groups increased significantly after exercise. The level of PAI did not change significantly with stress in either group. The level of plasminogen was significantly higher in the group taking contraceptives, whether before or after exercise, when compared to the control group. Levels of tPA and PAI, although slightly increased in the oral contraceptive group, were not significantly different between the two groups. The increase in plasminogen may be due to the estrogen component of the contraceptives. Stress seems to increase fibrinolytic response.
    Matched MeSH terms: Vascular Diseases
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