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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
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
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
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
Fulltext Dermatopathology of 400 skin biopsies from Sarawak

Yap FBB

Indian J Dermatol Venereol Leprol, 2009 Sep-Oct;75(5):518-9.
PMID: 19736441 DOI: 10.4103/0378-6323.55407
Matched MeSH terms: Retrospective Studies
Fulltext Long-term results of endoscopic resection of nasopharyngeal tumours

Tay HN, Leong JL, Sethi DS

Med J Malaysia, 2009 Jun;64(2):159-62.
PMID: 20058578

Traditional open approaches to the nasopharynx either provide limited access and risk significant morbidity. Here we describe our experience with endoscopic resection of nasopharyngeal tumours. Retrospective chart review was performed for all patients who underwent endoscopic nasopharyngeal resection from September 1993 to January 2007 at a tertiary rhinology centre. Six patients underwent endoscopic nasopharyngectomy for tumours arising from or involving the nasopharynx. The mean age was 49.8 years (range 23 - 70). The sex distribution was five males and one female. Four tumours were malignant and two were benign. The mean disease-free and overall survival for malignant tumors was 90.75 months (range 66 - 120 months). None of the benign tumors recurred. The endoscopic nasopharyngectomy technique may be successfully used for resection of tumors arising from or involving the nasopharynx with good efficacy and a decrease in morbidity when compared to open approaches.

Matched MeSH terms: Retrospective Studies
Mediation--the Malaysian Dental Association experience

Purmal K, Nambiar P

Int Dent J, 2009 Jun;59(3):155-60.
PMID: 19637524

To study the success and failures of the mediation process of complaints from 2004-2007 by the Complaints Bureau Steering Committee and the Public Complaints Bureau Committee of the Malaysian Dental Association (MDA).

Matched MeSH terms: Retrospective Studies
Pediatric cancer deaths: curative or palliative?

Menon BS, Mohamed M, Juraida E, Ibrahim H

J Palliat Med, 2008 Dec;11(10):1301-3.
PMID: 19115887 DOI: 10.1089/jpm.2008.0167

The aims of this study were to review the deaths of Malaysian pediatric oncology patients in order to determine the major causes and the proportion of patients who received palliative care.

Matched MeSH terms: Retrospective Studies
Laparoscopic appendicectomy: the ideal procedure for laparoscopic skill training for surgical registrars

Tata MD, Singh R, Bakar AA, Selvindoss P, P K, Gurunathan R

Asian J Surg, 2008 Apr;31(2):55-8.
PMID: 18490215

OBJECTIVE: Appendicectomy is a very common surgical procedure performed by registrars. It is mainly carried out by surgical registrars as an open procedure in many government hospitals. We aimed to evaluate laparoscopic appendicectomy as a laparoscopic training skill in a clinical setting for our registrars.
METHODS: A retrospective analysis of all attempted laparoscopic appendicectomies over 12 months by experienced surgeons and registrars was done. Factors evaluated were operating time, conversion rate, postoperative hospital stay, morbidity and mortality.
RESULTS: There was no statistically significant difference in operating time for surgeons and registrars (mean, 53 minutes vs. 60 minutes), conversion rate (10% vs. 11%). Mean hospital stay for patients operated on by surgeons was 3.1 days and 3.2 days for registrars. Morbidity was equal with both surgeons and registrars.
CONCLUSION: We conclude that laparoscopic appendicectomy is a safe laparoscopic training tool for registrars with basic laparoscopic knowledge who have had a proper apprenticeship, and can be done in a clinical setting.

Matched MeSH terms: Retrospective Studies
Fulltext Endocrine complications in transfusion dependent thalassaemia in Penang Hospital

Ong CK, Lim SL, Tan WC, Ong EE, Goh AS

Med J Malaysia, 2008 Jun;63(2):109-12.
PMID: 18942294 MyJurnal

Frequent blood transfusions can lead to iron overload which may result in several endocrine complications especially in the absence of adequate chelation therapy. The objectives of this study are to determine the prevalence of endocrine complications in transfusion dependent thalassaemia patients and the correlation of endocrine complications with the degree of iron chelation. This retrospective study looked at cases of adult patients with transfusion dependent thalassaemia treated in the Haematology Unit, Penang Hospital. Of the 25 transfusion dependent thalassaemia patients, there were 10 male and 15 female patients respectively with almost equal number of Malay and Chinese patients (13 and 12 patients respectively). Short stature was seen in 36.0% of our patients. In our cohort, 12 patients had delayed puberty (male 70.0% and female 33.3%). Prevalence of osteoporosis was 36.0%. Hypogonadism was noted in 40.0% of males and 46.7% of females. 53.4% of the female population had menstrual abnormalities with prevalence of primary and secondary amenorrhoea at 26.7% each. The prevalence of other endocrinopathies was much lower: 8.0% had diabetes mellitus and only one patient had hypocortisolism. Iron chelation appeared insufficient in our study population. The high frequency of endocrine complications noted in our study supports the rationale for regular follow-up of transfusion dependent thalassaemic patients to ensure early detection and timely treatment of associated complications.

Matched MeSH terms: Retrospective Studies
Fulltext Observation of spontaneous cerebrospinal fluid rhinorrhoea to body mass index: a preliminary report

Gendeh BS, Salina H

Med J Malaysia, 2007 Dec;62(5):368-9.
PMID: 18705467

The purpose of this retrospective study is to determine whether there is a correlation among overweight, gender and the risk of development of spontaneous cerebrospinal fluid (CSF) rhinorrhoea. The clinical data of eight patients diagnosed with spontaneous cerebrospinal fluid rhinorrhoea who had been treated at our tertiary referral centre between 1998 and 2007 were assessed. Demographically, seven patients were female and one male with ages ranging from 14 to 53 years with a mean age of 43.6 years. This observation revealed that all patients were overweight with a mean body mass index (BMI) of 32.5 kg/m2. This study suggests that there is a trend of increasing BMI to the risk of developing a spontaneous CSF rhinorrhoea.

Matched MeSH terms: Retrospective Studies
Childhood invasive pneumococcal disease: a hospital-based study from Malaysia

Lim LH, Lee WS, Parasakthi N

J Paediatr Child Health, 2007 May;43(5):366-9.
PMID: 17489826

New conjugate vaccine for Streptococcus pneumoniae has been introduced in Malaysia recently. Information on infection due to S. pneumoniae in Malaysian children is scarce. We conducted a retrospective chart review of childhood invasive pneumococcal disease (IPD) presented to a single centre in Malaysia.

Matched MeSH terms: Retrospective Studies
Fulltext Melioidosis in children from Kuala Lumpur, Malaysia

Sam IC, Puthucheary SD

Ann Trop Paediatr, 2006 Sep;26(3):219-24.
PMID: 16925959

There are few data on paediatric melioidosis in endemic areas outside rural north-eastern Thailand and northern Australia. This study reports 16 culture-confirmed cases of melioidosis in children aged < or = 15 years seen between 1976 and 2005 at an urban teaching hospital in Kuala Lumpur, Malaysia. Seven (43.8%) patients had septicaemic melioidosis (with three known deaths) and nine (56.2%) had localised disease (one death). Eleven (68.8%) patients had underlying diseases, including five with haematological malignancies. Skin, soft tissue and lymph nodes were most commonly affected. There were no cases of parotitis or pharyngocervical disease (seen in Thailand), or encephalomyelitis (seen in Australia). The differences in disease seen in this study compared with the mostly rural patients described in previous studies might be owing to a different patient population in an urban environment. Septicaemic melioidosis has a high mortality, but localised disease has a good prognosis, and selected cases may be cured without the full recommended treatment regimen.

Matched MeSH terms: Retrospective Studies
Fulltext Outbreak of influenza amongst residential school students in Malaysia

Ayob A, Selviendran N, Hampson AW, Barr IG, Kumarasamy V, Chua KB

Med J Malaysia, 2006 Jun;61(2):168-72.
PMID: 16898307 MyJurnal

In the months of July and August 2003, an outbreak of acute respiratory illness caused by influenza A virus occurred among students in seven residential schools situated in the northern part (Perak) of Peninsular Malaysia. Out of 4989 students, aged 13 to 18 years (mean = 15.9), 1419 (28%) were effected by influenza-like illness. All patients were treated as outpatients except for 36 students who required admission for high fever, severe coughing and shortness of breath. Abnormal chest X-ray findings were noted for those that required inpatient management. Influenza A virus was isolated from 37 sputum specimens, 20 throat swabs and three nasal swab specimens from a total of 278 clinical samples obtained from 180 patients. Isolates from each of the outbreaks were sent to WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, Australia for antigenic and genetic analysis. One school outbreak was due to influenza A (H1N1), A/New Caledonia/20/99-like virus while the other six school outbreaks were due to influenza A (H3N2) viruses which were A/Fujian/411/2002-like).

Matched MeSH terms: Retrospective Studies
Fulltext Melioidosis: the Johor Bahru experience

Pagalavan L

Med J Malaysia, 2005 Dec;60(5):599-605.
PMID: 16515111

A 5 year retrospective review of cases of melioidosis was carried out in Sultanah Aminah Hospital, Johor Bahru. There were 44 new cases of melioidosis which was proven by either blood or pus culture growing Burkholderia pseudomallei from the period between January 1999 and December 2003. Of these, 38 (86.4%) were males compared to only 6 (13.6%) females. Thirty-one (70.5%) were Malays, 7 (15.9%) were Chinese, 5 (11.4%) were Indians and 1 (2.2%) was a Sarawakian. The peak age group was between 50 and 59 years (31.8%). Out of these 44 new cases, only 32 medical records could be retrieved and analysed. Twenty-four out of 32 patients (75%) analysed had diabetes mellitus, 4 had chronic or end stage renal failure (CRF/ESRF) and only 1 had Human Immunodeficiency Virus (HIV). One case of "near drowning" was also recorded. Twenty-one out of 44 patients or 47.7% died, of which 8 (38.1%) died within 24 hours of admission. Pulmonary involvement was recorded in 62.6% of the patients but many had signs and symptoms of multiorgan involvement.

Matched MeSH terms: Retrospective Studies
Fulltext Prevalence of risk factors and its gender difference among stroke patients

Norsa'adah B

Med J Malaysia, 2005 Dec;60(5):670-1.
PMID: 16515127
Matched MeSH terms: Retrospective Studies
Fulltext Characteristics of seizure frequency among Malaysian children diagnosed with structural-metabolic epilepsy

Salih MR, Bahari MB, Hassali MA, Shafie AA, Al-Lela OQ, Abd AY, et al.

J Neurosci Rural Pract, 2012 Sep;3(3):244-50.
PMID: 23188969 DOI: 10.4103/0976-3147.102596

INTRODUCTION: Seizure-free patients or substantial reduction in seizure frequency are the most important outcome measures in the management of epilepsy. The study aimed to evaluate the patterns of seizure frequency and its relationship with demographics, clinical characteristics, and outcomes.
MATERIALS AND METHODS: A retrospective cohort study was conducted at the Pediatric Neurology Clinic, Hospital Pulau Pinang. Over a period of 6 months, the required data were extracted from the medical records using a pre-designed data collection form.
RESULTS: Seizure frequency showed no significant association with patient's demographics and clinical characteristic. However, significant reduction in seizure frequency from the baseline to the last follow-up visit was only seen in certain subgroups of patients including Malays, females, patients <4 years of age, patients with global developmental delay/intellectual disability, and patients with focal seizure. There was no significant association between seizure frequency and rate of adverse events. Polytherapy visits were associated with higher seizure frequency than monotherapy visits (27.97 ± 56.66, 10.94 ± 30.96 attack per month, respectively) (P < 0.001). There was a clear tendency to get antiepileptic drugs used at doses above the recommended range in polytherapy (8.4%) rather than in monotherapy (1.4%) visits (P < 0.001). A significant correlation was found between seizure frequency and number of visits per patient per year (r = 0.450, P < 0.001).
CONCLUSION: Among children with structural-metabolic epilepsy, Malays, females, patients <4 years of age, patients with global developmental delay/intellectual disability and patients manifested with focal seizure are more responsive antiepileptic drug therapy than the other subgroups of patients.

Matched MeSH terms: Retrospective Studies
Fulltext Assessment of dental caries predictors in 6-year-old school children - results from 5-year retrospective cohort study

Masood M, Yusof N, Hassan MI, Jaafar N

BMC Public Health, 2012;12:989.
PMID: 23158416 DOI: 10.1186/1471-2458-12-989

This was a retrospective cohort study undertaken to assess the rate and pattern of dental caries development in 6-year-old school children followed-up for a period of 5 years, and to identify baseline risk factors that were associated with 5 years caries experience in Malaysian children.

Matched MeSH terms: Retrospective Studies
Fulltext Biopsy-proven childhood glomerulonephritis in Johor

Khoo JJ, Pee S, Thevarajah B, Yap YC, Chin CK

Med J Malaysia, 2004 Jun;59(2):218-25.
PMID: 15559173 MyJurnal

Background: There has been no published study of biopsy proven childhood glomerulonephritis in Malaysia.
Objectives: To determine the pattern of childhood glomerulonephritis in Johor, Malaysia from a histopathological perspective and the various indications used for renal biopsy in children.
Materials and methods: Retrospective study was done of all renal biopsies from children under 16 years of age, received in Sultanah Aminah Hospital, Johor between 1994 and 2001. The histopathological findings were reviewed to determine the pattern of biopsy proven glomerulonephritis. The indications of biopsy, mode of therapy given after biopsy and the clinical outcome were studied.
Results: 123 adequate biopsies were received, 9 children had repeated biopsies. Of the 113 biopsies, minimal change disease formed the most common histopathological diagnosis (40.7%) while lupus nephritis formed the most common secondary glomerulonephritis (23.0%). The main indications for biopsy were nephrotic syndrome (50.8%), lupus nephritis (25.4%) and renal impairment (13.1%). The mode of therapy was changed in 59.8% of the children. Of 106 patients followed up, 84 children were found to have normal renal function in remission or on treatment. 4 patients developed chronic renal impairment and 16 reached end stage renal disease. Five of the 16 children with end stage disease had since died while 11 were on renal replacement therapy. another 2 patients died of other complications.
Conclusions: The pattern of childhood GN in our study tended to reflect the more severe renal parenchymal diseases in children and those requiring more aggressive treatment. This was because of our criteria of selection (indication) for renal biopsy. Renal biopsy where performed appropriately in selected children may not only be a useful investigative tool for histological diagnosis and prognosis but may help clinicians plan the optimal therapy for these children.

Matched MeSH terms: Retrospective Studies
Attainment of goal and normalized lipid levels with lipid-modifying therapy in Malaysia

Hsu TY, Chirovsky D, Moy FM, Ambegaonkar BM

Clin Ther, 2013 Apr;35(4):450-60.
PMID: 23481458 DOI: 10.1016/j.clinthera.2013.02.004

Although LDL-C is the primary lipid target for coronary heart disease (CHD) risk reduction, HDL-C and triglycerides (TG) have also emerged as CHD risk factors.

Matched MeSH terms: Retrospective Studies

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