MyMedR

Wang CY, Yap BH, Delilkan AE

Chest, 1993 Jun;103(6):1897-9.

We present the case of a 24-year-old woman with acute septicemic melioidosis resulting from inhaled infective dust during a blast injury. With appropriate antibiotic treatment and supportive therapy in the ICU, the patient made an uneventful recovery.

Matched MeSH terms: Blast Injuries/complications*

Application of autonomous neural network systems to medical pattern classification tasks

Lim CP, Harrison RF, Kennedy RL

Artif Intell Med, 1997 Nov;11(3):215-39.

PMID: 9413607

This paper presents a study of the application of autonomously learning multiple neural network systems to medical pattern classification tasks. In our earlier work, a hybrid neural network architecture has been developed for on-line learning and probability estimation tasks. The network has been shown to be capable of asymptotically achieving the Bayes optimal classification rates, on-line, in a number of benchmark classification experiments. In the context of pattern classification, however, the concept of multiple classifier systems has been proposed to improve the performance of a single classifier. Thus, three decision combination algorithms have been implemented to produce a multiple neural network classifier system. Here the applicability of the system is assessed using patient records in two medical domains. The first task is the prognosis of patients admitted to coronary care units; whereas the second is the prediction of survival in trauma patients. The results are compared with those from logistic regression models, and implications of the system as a useful clinical diagnostic tool are discussed.

Matched MeSH terms: Wounds and Injuries/physiopathology

Anatomy of a burns disaster: the Miri Bank explosion

Wu WT, Ngim RC

Ann Acad Med Singap, 1992 Sep;21(5):640-8.

PMID: 1292393

A bank explosion in a neighbouring country over 1000 km away resulted in ten badly burned victims being airlifted to the Burns Centre, Singapore General Hospital (BCSGH) for treatment. The severely injured included patients with 90%, 80%, 74%, 66%, 45%, 33% and 31% burns. Nine had respiratory burns (four severe, one moderate, four mild). One patient died, thus, the mortality rate for the six most severely injured was 16.7%. This differs from predicted mortality rates of 78% according to McCoy or 54% according to Thompson, Herndon et al. The factors contributing to this result were the small size of the disaster, the use of an established Burns Mass Disaster plan and an individual management policy that incorporates carefully monitored fluid resuscitation, recognition of respiratory burns with early treatment by intubation thus pre emptying complications, early surgery and a multidisciplinary approach to complications such as infection and renal failure. The average length of stay was 43 days (range 5-122 days). The cost of the hospitalisation of the ten casualties was $312,317.00.

Matched MeSH terms: Blast Injuries/therapy*

Fulltext Necrotizing fasciitis

Zubaidah AW, Lim VKE

Med J Malaysia, 1996 Mar;51(1):134-6.

PMID: 10967993

A 31-year-old Pakistani man was admitted to hospital after sustaining a Grade I compound fracture of the mid-shaft of the left tibia and fibula following a motor vehicle accident. He developed septicaemic shock, acute renal failure and Group A streptococcal necrotizing fasciitis of the left leg. The patient underwent an above knee amputation followed by disarticulation of the left hip with extensive debridement. He was treated with benzylpenicillin, vancomycin, inotropes and continuous haemodialysis and survived without further sequelae. Subsequently, skin grafting was done over the wound site. This case highlights the role of Group A streptococcus as a cause of this rare and life-threatening infection.

Matched MeSH terms: Leg Injuries/surgery*

Fulltext The use of interventional radiology in ruptured solitary kidneys

Lei CC, Khairullah A, Zulfiqar A, Samad AS

Med J Malaysia, 1992 Dec;47(4):320-2.

PMID: 1303487

This case report illustrates how a life-threatening renal bleeding which has failed to be controlled by open surgery can be elegantly managed by a minimally invasive technique of interventional radiology. It also allows maximal conservation of renal tissue so that the patient can avoid chronic dialysis or renal transplantation.

Matched MeSH terms: Kidney/injuries*

Fulltext A study of perforating eye injuries at the Ophthalmology Department, National University of Malaysia

Zainal M, Goh PP

Med J Malaysia, 1997 Mar;52(1):12-6.

PMID: 10968048

One hundred and sixty seven (167) perforating eye injuries involving 159 patients were analyzed in a retrospective study over a three-year period. The degree of blindness and their associated factors were determined. Most patients were in the first three decades of life and were males. One hundred and seven (64%) eyes had vision of 3/60 or worse at initial assessment. Of these only 45% of eyes had improved vision to 6/36 or better at six months of follow-up. Fifty-five per cent of eyes were blind. The only significant associated factor identified was the extent of injury. Age, time interval and mechanism of injury were not significant factors.

Matched MeSH terms: Eye Injuries/epidemiology*

Hypodense bubbles in acute extradural haematomas following venous sinus tear. A CT scan appearance

Chee CP, Habib ZA

Neuroradiology, 1991;33(2):152-4.

PMID: 2046901

Between January 1982 and December 1989, 12 patients with 13 acute extradural haematomas as a result of injury involving the venous sinuses were treated by the first author. The CT scan appearances in 6 cases were remarkable in that there were large bubbles of low density in the hyperdense haematomas and liquid blood was found during the operation. The possible underlying pathophysiological changes that gave rise to this appearance are discussed. The CT scan appearance and the proximity of the clot to the venous sinuses should alert the neurosurgeon to the high probabilities of venous sinus tear such that proper treatment can be offered.

Matched MeSH terms: Cranial Sinuses/injuries

Fulltext Renal trauma: a local experience

Mack POP, Ng HN

Med J Malaysia, 1985 Dec;40(4):312-6.

PMID: 3842731

40 cases of major renal trauma over a period of five years in a peripheral hospital in Singapore were reviewed. 90% were due to blunt trauma with motor-cycle accidents forming the majority. There were five cases of superficial cortical injury, three cases of shattered kidneys, six cases of parenchymal injuries, one case of pedicle injury and one case of combined pedicle and parenchymal injury. Nephrectomy rate was 22.5% in this series. This is felt to be unduly high. Half of all the cases operated upon ended up with an immediate total nephrectomy. There was no mortality in this series. We recommend a more conservative policy of watchful waiting to achieve better chances of organ preservation without increasing mortality.

Matched MeSH terms: Kidney/injuries*

Fulltext Continuous brachial plexus block--regional anaesthesia for reimplantation surgery of the hand: a preliminary study

Sivarajah RS, Keh SA, Ong G, Teo WS, Delilkan AE

Med J Malaysia, 1984 Jun;39(2):112-5.

PMID: 6513849

Continuous brachial plexus block in six patients undergoing reimplantation of severed fingers or hand is described. The technique involved placement of a catheter within the neurovascular sheath enclosing the brachial plexus. This enabled us to give the local anaesthetic as required to last the whole duration of surgery.

Matched MeSH terms: Hand Injuries/surgery*

Hepatic resections 1964-1979: vignettes drawn from the Malaysian experience

Balasegaram M, Joishy SK

Jpn J Surg, 1980 Jun;10(2):94-9.

PMID: 6253701

We present a study of 288 hepatic resections carried out in Malaysia for the past fifteen years. First, we describe our indications for hepatic resectins which are not limited to hepatic trauma and hepatomas, but also include hepatic abscesses, cysts, intrahepatic calculi and hemangiomas. Second, we give a simplified classification of hepatic resections using accurate terminology. Third, we describe the safety of hepatic resections in our hands which we believe is due to specially designed surgical instruments and the accurate decision making process at surgery. We have had minimum postoperative mortality and no intraoperative deaths so far. Finally, while analysing each indication we have drawn vignettes from our experience for the past fifteen years.

Matched MeSH terms: Liver/injuries

Fulltext A review of intraocular foreign bodies treated at the University Hospital Kuala Lumpur

Teoh GH, Yow CS

Med J Malaysia, 1982 Mar;37(1):7-10.

PMID: 7121351

A retrospective study of intraocular foreign bodies treated at the University Hospital over 10 years from 1970 - 1979 was carried out. Of the 48 cases reviewed, nine were anterior chamber foreign bodies while the rest were posterior segment foreign bodies. The anterior chamber foreign bodies had better visual prognosis as compared to the posterior segment foreign bodies. Most of the patients were young Chinese males and most of the injuries were due to accidents at work involving the 'hand hammer' (includes other implements used as a hammer).

Matched MeSH terms: Anterior Chamber/injuries

Fulltext Temporomandibular pain dysfunction syndrome - an analysis of fifty patients

Yaacob HB, Ling BC

Med J Malaysia, 1981 Jun;36(2):83-6.

PMID: 7343824

Fifty patients with temporomandibular pain dysfunction syndrome were examined. Seventy-eight percent and 32 percent were female and male respectively. The white collar workers were more frequently affected. Emotional stress, dental malocclusion and a history of trauma were the main causes. Treatment consists of reassurance, relaxed jaw movements and exercises, anxiolytic drugs, thermotherapy, biting appliance, occlusal adjustments and restoration oflost dental units.

Matched MeSH terms: Wounds and Injuries/complications

Middle third fractures of facial skeleton at University Hospital, Kuala Lumpur: a retrospective study

Nor GM, Lian CB

Singapore Dent J, 1988 Dec;13(1):31-2.

PMID: 3155001

This is a retrospective study of 80 patients with major central and lateral middle third fractures of facial skeleton treated at University Hospital from 1981 to 1985. The most common was the fractures of zygomatic complex. The peak incidence was in the 20-29 year age group and males were involved more than females (ratio 9: 1). Road traffic accidents were to be blamed for most of the fractures which was 82.25%.

Matched MeSH terms: Maxillofacial Injuries/epidemiology*

Management of an avulsed tooth with severe root resorption

Meon R

Singapore Dent J, 1988 Dec;13(1):53-6.

PMID: 3155008

Delayed replantation of an avulsed tooth with an open apex resulted in failure of revascularization, necrosis of the pulp and extensive external root resorption. Removal of the necrotic pulp and repeated intra-canal dressings of calcium hydroxide over a three year period arrested the inflammatory resorptive process. The process was replaced by replacement resorption leading to ankylosis and infra-occlusion of the affected tooth. As the tooth was asymptomatic, it was retained in the arch to act as a space maintainer. To improve aesthetics, the crown was recontoured using a light-cured resin.

Matched MeSH terms: Incisor/injuries

Fulltext Massage-related perforation of the sigmoid colon in Kelantan

Gohar Rahman MN, McAll G, Koh GC

Med J Malaysia, 1987 Mar;42(1):56-7.

PMID: 3431504

Perforation of the sigmoid colon is an occasional complication of blunt injury to the abdomen. We report three cases following abdominal massage (urut) by traditional healers (bomohs) in which no other underlying pathology was found.

Matched MeSH terms: Colon, Sigmoid/injuries*

Fulltext Juvenile rhegmatogenous retinal detachment in Malaysia

Singh M

Med J Malaysia, 1986 Jun;41(2):156-60.

PMID: 3821612

45 patients (50 eyes) were treated for juvenile rhegmatogenous retinal detachments between August 1979 and July 1984. A review of these cases revealed high myopia and trauma to be the main aetiological factors. Eight-six per cent detachments were successfully reattached. Visual acuity of 6/36 or better was present in 16% preoperatively and in 52% postoperatively, some of the characteristics of juvenile rhegmatogenous retinal detachments in Malaysian population are discussed.

Matched MeSH terms: Eye Injuries/complications

Fulltext Coital injuries: a study of three cases

Narkunam R, Raman S, Kulenthran A, Sinnathuray TA

Med J Malaysia, 1984 Mar;39(1):78-81.

PMID: 6513845

This study reviews experiences in the management of three cases of lacerations of the vagina following coitus. A brief review of the recent literature is made. Although the extent of injuries can be very variable, the principles of management consist of prompt
resuscitation and arrest of haemorrhage, appropriate surgical repair under general anaesthesia, and systemic or local antibiotic therapy to combat infection. Avoidance of vigorous or abnormal coital practices, especially in single women, in the immediate postpartum period, and in postmenopausal women, can help to reduce the frequency and severity of such injuries.

Matched MeSH terms: Vagina/injuries*

Review of patients with multiple injuries treated at University Hospital, Kuala Lumpur

Silva JF

J Trauma, 1984 Jun;24(6):526-31.

PMID: 6737530

This study has analyzed 260 patients with multiple injuries sustained in road accidents admitted to the University Hospital during the period July 1967 to July 1976, in relation to age, sex, and ethnic distribution. The types of injuries sustained have been discussed to highlight their effects on the community in a developing country. The extremities have been most frequently involved, while head injuries followed closely. The causative factors of multiple injury-producing accidents have been evaluated. The categories of victims most liable to multiple injuries have been discussed. The significance of understanding the mechanism of these accidents and the effect of such knowledge in minimizing diagnostic errors, thus enabling management and the urgent need for regional accident services in developing countries, have been stressed.

Matched MeSH terms: Wounds and Injuries/epidemiology*

A survey of ocular injuries at the University Hospital

Chandran S, Eu-Sen VO

Med J Malaya, 1971 Jun;25(4):278-81.

PMID: 4261300

Matched MeSH terms: Eye Injuries/epidemiology*

Fulltext Clinical characteristics of 1653 injured motorcyclists and factors that predict mortality from motorcycle crashes in Malaysia

Tan Chor Lip H, Tan JH, Mohamad Y, Ariffin AC, Imran R, Azmah Tuan Mat TN

Chin J Traumatol, 2019 Apr;22(2):69-74.

PMID: 30583984 DOI: 10.1016/j.cjtee.2018.11.001

PURPOSE: Amongst the ASEAN countries, Malaysia has the highest road fatality risk (>15 fatalities per 100 000 population) with 50% of these fatalities involving motorcyclist. This contributes greatly to ward admissions and poses a significant burden to the general surgery services. From mild rib fractures to severe intra-abdominal exsanguinations, the spectrum of cases managed by surgeons resulting from motorcycle accidents is extensive. The objective of this study is to report the clinical characteristics and identify predictors of death in motorcycle traumatic injuries from a Malaysian trauma surgery centre.

METHODS: This is a prospective cross-sectional study of all injured motorcyclists and pillion riders that were admitted to Hospital Sultanah Aminah and treated by the trauma surgery team from May 2011 to February 2015. Only injured motorcyclists and pillion riders were included in this study. Patient demography and predictors leading to mortality were identified. Significant predictors on univariate analysis were further analysed with multivariate analysis.

RESULTS: We included 1653 patients with a mean age of (35 ± 16.17) years that were treated for traumatic injuries due to motorcycle accidents. The mortality rate was 8.6% (142) with equal amount of motorcycle riders (788) and pillion riders (865) that were injured. Amongst the injured were male predominant (1 537) and majority of ethnic groups were the Malays (897) and Chinese (350). Severity of injury was reflected with a mean Revised Trauma Score (RTS) of 7.31 ± 1.29, New Injury Severity Score (NISS) of 19.84 ± 13.84 and Trauma and Injury Severity Score (TRISS) of 0.91 ± 0.15. Univariate and multivariate analysis revealed that age≥35, lower GCS, head injuries, chest injuries, liver injuries, and small bowel injuries were significant predictors of motorcycle trauma related deaths with p

Matched MeSH terms: Wounds and Injuries/epidemiology*

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