MyMedR

Occurrence of vancomycin-resistant enterococci in ducks in Malaysia

Shah-Majid M, Azlina AM, Ana Maria AR, Zaharah B, Norhaliza AH

Vet Rec, 2004 Nov 20;155(21):680-1.

Prevalence of dengue fever and dengue hemorrhagic fever in Hospital Tengku Ampuan Rahimah, Klang, Selangor, Malaysia

Jamaiah I, Rohela M, Nissapatorn V, Maizatulhikma MM, Norazlinda R, Syaheerah H, et al.

Southeast Asian J. Trop. Med. Public Health, 2005;36 Suppl 4:196-201.

Dengue fever and dengue hemorrhagic fever have been known to be endemic and reportable diseases in Malaysia since 1971. Major outbreaks occurred in 1973, 1982 and in 1998. For the past few decades until now. many studies have been performed to investigate the importance of these two diseases in Malaysia. A retrospective study was carried out in Hospital Tengku Ampuan Rahimah Klang to find the prevalence of these diseases. The data was collected from the record department of this hospital starting from the year 1999 until 2003 (5 years). A total of 6,577 cases of dengue fever and 857 cases of dengue hemorrhagic fever were reported. From the year 2000 onwards, cases of dengue fever had increased tremendously. However for the year 2001, there was a slight decrease in the reported cases. Most cases occurred in 2003, increasing from 674 in 1999 to 2,813 in 2003. Highest incidence was seen in Malay males more than 12 years of age. However, the cases of dengue hemorrhagic fever declined tremendously throughout the years. Most cases occurred in 1999 with 674 cases, then declining to only one in the year 2001 before it increased to 60 and 72 in the years 2002 and 2003, respectively. Most cases occurred in patients above 12 years old, the majority of which were Malay males.

A comparison of the pattern of liver involvement in dengue hemorrhagic fever with classic dengue fever

Wahid SF, Sanusi S, Zawawi MM, Ali RA

Southeast Asian J. Trop. Med. Public Health, 2000 Jun;31(2):259-63.

PMID: 11127322

The impact of dengue on liver function was studied on fifty serologically confirmed dengue cases admitted to Hospital Universiti Kebangsaan Malaysia (HUKM). Twenty-five of these patients had classic dengue fever (DF) and 25 had grade 1 or 2 dengue hemorrhagic fever (DHF). There were more (60%) DHF patients with hepatomegaly compared to DF (40%) but the difference was not statistically significant. Analysis of the liver profile showed that liver dysfunction was commoner in DHF compared to DF, indicating that the degree of liver impairment may be related to the severity of DHF. Hyperbilirubinemia was noted in 3 (12%) DHF and 2 (8%) DF patients. The mean (range) serum bilirubin was higher in DHF [14.2(5-50) micromol/l] compared to DF [10.9(5-30) micromol/l)] (p > 0.05). Elevated levels of serum alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were observed more frequently in DHF (20 and 12 patients respectively) compared to DF (16 and 8 patients respectively). Nine (36%) DHF and 6 (24%) DF patients had concomitant elevation of ALT and ALP levels. The mean (range) serum ALT levels were 109.3(23-325) U/l in DHF and 90.8(13-352) U/l in DF (p > 0.05). The mean (range) serum ALP levels were 102.2(15-319) U/l in DHF and 93.3(34-258) U/l in DF (p > 0.05). The ALT and ALP levels were significantly higher in DHF patients with spontaneous bleeding than those without bleeding (p < 0.05) None of the patients developed fulminant hepatitis. The immunoregulatory cells, which include the T (CD3), B (CD 19), CD4, CD8, CD5 and natural killer (NK) cells were significantly lower in DHF compared to DF patients (p < 0.05). However, the reduction in these cell counts did not correlate with the liver dysfunction seen in DHF patients. In conclusion, hepatomegaly and liver dysfunction were commoner in DHF compared to DF.

HLA and filariasis in Sri Lankans and Indians

Chan SH, Dissanayake S, Mak JW, Ismail MM, Wee GB, Srinivasan N, et al.

Southeast Asian J. Trop. Med. Public Health, 1984 Sep;15(3):281-6.

PMID: 6523169

Similar HLA association was found in patients with elephantiasis in Sri Lankans and Southern Indians. HLA-B15 was observed in 13/44 (30%) Sri Lankan patients with elephantiasis compared to 1/27 (4%) Sri Lankan controls (p = .0058; RR = 10.9) and in 5/8 (28%) Southern Indian elephantiasis compared to 10/101 (10%) Southern Indian controls (p = 0.04; RR = 3.5). In combining the data, the significance of the difference of the frequency of B15 between patients with elephantiasis and controls was even more marked (p = 0.00045; corrected p = 0.012; RR = 4.4).

Fulltext Pyrolysis of polypropylene plastic waste into carbonaceous char: Priority of plastic waste management amidst COVID-19 pandemic

Harussani MM, Sapuan SM, Rashid U, Khalina A, Ilyas RA

Sci Total Environ, 2022 Jan 10;803:149911.

PMID: 34525745 DOI: 10.1016/j.scitotenv.2021.149911

COVID-19 global pandemic, originated from Wuhan, resulted in a massive increase in the output of polypropylene (PP)-based personal protective equipment (PPE) for healthcare workers. The continuous demand of PPE across the world caused the PP based plastic wastes accumulation. Some alternative approaches that have been practiced apart from collecting the plastic waste in the landfills are incineration approach and open burning. However, there were many drawbacks of these practices, which promote the release of chemical additives and greenhouse gases into the environment. Therefore, a proper approach in treating the plastic wastes, which introduces conversion of plastic wastes into renewable energy is paramount. Along the way of extensive research and studies, the recovery of PP plastic to fuel-like liquid oil and solid char through thermal decomposition of pyrolysis process, helps in reducing the number of PP plastic wastes and produces good quality pyrolysis liquid oil and solid char to be used in fuel applications. This paper summarizes the pyrolysis process for massively produced PP plastic wastes, type of pyrolysis used and the main pyrolysis parameters affecting the product yields. Literature studies of pyrolysis of PP plastic and several key points to optimize solid char production for PP were thoroughly elaborated in this review paper.

Fulltext Breast Cancer Risk Genes - Association Analysis in More than 113,000 Women

Breast Cancer Association Consortium, Dorling L, Carvalho S, Allen J, González-Neira A, Luccarini C, et al.

N Engl J Med, 2021 02 04;384(5):428-439.

PMID: 33471991 DOI: 10.1056/NEJMoa1913948

BACKGROUND: Genetic testing for breast cancer susceptibility is widely used, but for many genes, evidence of an association with breast cancer is weak, underlying risk estimates are imprecise, and reliable subtype-specific risk estimates are lacking.

METHODS: We used a panel of 34 putative susceptibility genes to perform sequencing on samples from 60,466 women with breast cancer and 53,461 controls. In separate analyses for protein-truncating variants and rare missense variants in these genes, we estimated odds ratios for breast cancer overall and tumor subtypes. We evaluated missense-variant associations according to domain and classification of pathogenicity.

RESULTS: Protein-truncating variants in 5 genes (ATM, BRCA1, BRCA2, CHEK2, and PALB2) were associated with a risk of breast cancer overall with a P value of less than 0.0001. Protein-truncating variants in 4 other genes (BARD1, RAD51C, RAD51D, and TP53) were associated with a risk of breast cancer overall with a P value of less than 0.05 and a Bayesian false-discovery probability of less than 0.05. For protein-truncating variants in 19 of the remaining 25 genes, the upper limit of the 95% confidence interval of the odds ratio for breast cancer overall was less than 2.0. For protein-truncating variants in ATM and CHEK2, odds ratios were higher for estrogen receptor (ER)-positive disease than for ER-negative disease; for protein-truncating variants in BARD1, BRCA1, BRCA2, PALB2, RAD51C, and RAD51D, odds ratios were higher for ER-negative disease than for ER-positive disease. Rare missense variants (in aggregate) in ATM, CHEK2, and TP53 were associated with a risk of breast cancer overall with a P value of less than 0.001. For BRCA1, BRCA2, and TP53, missense variants (in aggregate) that would be classified as pathogenic according to standard criteria were associated with a risk of breast cancer overall, with the risk being similar to that of protein-truncating variants.

CONCLUSIONS: The results of this study define the genes that are most clinically useful for inclusion on panels for the prediction of breast cancer risk, as well as provide estimates of the risks associated with protein-truncating variants, to guide genetic counseling. (Funded by European Union Horizon 2020 programs and others.).

Fulltext An unexpected lesion in cerebellopontine angle: hemangiopericytoma

Teoh JW, Goh BS, Shahizon Azura MM, Siti Aishah MA, Nor Hafliza MS

Med J Malaysia, 2014 Jun;69(3):146-7.

PMID: 25326360 MyJurnal

hemangiopericytoma (hPC) is a rare tumor by definition and intracranial hPC makes up to less than one percent of all the intracranial tumors. It is a dural base tumor and its clinical features and radiological findings are similar to meningiomas. however, cerebellopontine angle hemangipericytoma had only been reported twice and would almost always be misdiagnosed. definite diagnosis is important, as the treatment of hPC is different from meningiomas and acoustic neuromas. we report a case of a young female who presented with atypical symptoms of left cerebellopontine angle mass. A literature review of the nature of the disease, radiological findings, immunohistochemical features and treatment options of the tumor are described.

Fulltext Langerhans cell histiocytosis in an adult - a rare, life-threatening and not to be missed

Lai JY, Tang MM, Priya G, Rajasuriar JS, Suganthi T

Med J Malaysia, 2014 Apr;69(2):95-7.

PMID: 25241821

Langerhans Cell Histiocytosis (LCH) is an uncommon neoplastic disorder characterized by accumulation of histiocytes in various tissues. The clinical manifestation is highly variable, ranging from an isolated skin rash or a single bony lesion, to fatal multi-organ failure. Due to its rarity and systemic involvement, the epidemiology of LCH is still not fully understood and most studies focus on the paediatric population. The extent of clinical involvement has important prognostic implications. Treatment options may be local or systemic depending on disease extent. Here we describe a rare case of adult onset LCH who presented with recurrent pneumothoraces, diabetes insipidus and papules and plaques over the scalp and forehead.

Fulltext Chest x-ray as an essential part of routine medical examination: is it necessary?

Izamin I, Rizal AM

Med J Malaysia, 2012 Dec;67(6):606-9.

PMID: 23770954 MyJurnal

INTRODUCTION: Various studies in primary care and hospitalized patients have discouraged routine use of chest x-ray (CXR) in medical examination.
PURPOSE: The study aims to determine the prevalence of abnormal routine CXR and cost of one CXR at a public health clinic and discuss the rationale of CXR in routine medical examination.
METHODOLOGY: Data of patients who visited Klinik Kesihatan Bandar Kota Bharu (KKBKB), a public health clinic, from 1 January until 31 December 2010 were examined. The study used cross-sectional design. All patients who came for medical examination and CXR at KKBKB were included. Cost analysis was performed from the perspective of provider.
FINDINGS: About 63.1% of 8315 CXR films in KKBKB were produced as part of routine medical examination. Prevalence of abnormal CXR was 0.25%. The cost of producing one CXR ranges from RM15.87 to RM32.34.
DISCUSSION: Low yield from CXR screening and high cost of CXR are the main concern. CXR screening would also lead to unnecessary radiation; and false-positive screening resulting in physical risk, unwarranted anxiety and more expenditure. CXR screening is appropriately reserved for high-risk patients and those with relevant clinical findings.

Fulltext Association of creatinine clearance with neutropenia in breast cancer patients undergoing chemotherapy with fluorouracil, doxorubicin, and cyclophosphamide (FAC)

Montoya JE, Luna HG, Morelos AB, Catedral MM, Lava AL, Amparo JR, et al.

Med J Malaysia, 2013 Apr;68(2):153-6.

PMID: 23629563

Fluorouracil, doxorubicin, cyclophosphamide protocol (FAC) is a commonly used regimen for breast cancer due to its proven efficacy, acceptable toxicity, high affordability. While hepatic insufficiency dosing for doxorubicin and fluorouracil have been set, there is paucity of data in the literature on how to reduce doses in renal insufficiency. We sought to determine whether there is an association with pre-chemotherapy creatinine clearance, and the occurrence of clinically significant grade 3 to 5 neutropenia during the course of FAC chemotherapy.

Fulltext Spinal cord compression following traditional confinement massage

Sahathevan R, Tan HJ, Abdullah S, Shahizon AM, Hamidon BB, Raymond AA

Med J Malaysia, 2011 Dec;66(5):495-6.

PMID: 22390109 MyJurnal

We describe a case of tetraparesis in a 33-year-old woman following neck manipulation performed by a traditional confinement mid-wife. An MRI of the cervical spine revealed a fracture of the second cervical vertebra with atlanto-axial subluxation that resulted in cord compression.

Fulltext Intraparotid facial nerve schwannoma: a case report

Irfan M, Shahid H, Yusri MM, Venkatesh RN

Med J Malaysia, 2011 Jun;66(2):150-1.

PMID: 22106700 MyJurnal

Schwannoma in the head and neck region is very rare. The tumour occurring in the intraparotid facial nerve is even rarer. A patient presenting with a parotid swelling with facial nerve paralysis is not pathognomonic of a facial nerve schwannoma. However it may occur because enlargement of the parotid, by any kind of tumour especially a malignant one can cause facial nerve paralysis. We report a case of an intraparotid facial nerve schwannoma, in a patient who presented with parotid enlargement and facial nerve paralysis.

Fulltext Intravenous ketamine is as effective as midazolam/fentanyl for procedural sedation and analgesia in the emergency department

Jamal SM, Fathil SM, Nidzwani MM, Ismail AK, Yatim FM

Med J Malaysia, 2011 Aug;66(3):231-3.

PMID: 22111446

The study compared the effectiveness of ketamine and midazolam/fentanyl as procedural sedation and analgesia agents for reduction of fractures and dislocated joints. Forty-one adult patients were enrolled by convenience sampling. They were randomized to receive ketamine or midazolam/fentanyl. Depth of sedation, pain score, procedural outcome and memory of the procedure were documented. The ketamine group had deeper sedation, but there was no statistical difference in other variables between the two groups. Three patients in the midazolam/fentanyl group had oxygen desaturation. More adverse effects were associated with ketamine. Intravenous ketamine is as effective as midazolam/fentanyl for procedural sedation.

Fulltext Retrospective review of surgical management of foreign body ingestion

Shaariyah MM, Goh BS

Med J Malaysia, 2009 Dec;64(4):307-10.

PMID: 20954556 MyJurnal

Endoscopic examination and removal of foreign body under general anaesthesia are recommended for persistent symptomatic patient with or without significant findings on radiological examination. This report evaluates the management outcome of surgical removal of foreign body ingestion in upper gastrointestinal tract. A total of 70 cases with full documentation were reviewed retrospectively from June 1998 until December 2007. There were 32 male and 38 female with age range from 6 months to 87 years old (mean: 36.9 years). Sixty five patients (93%) were adults and 15 (7%) were below 13 years. Fish bones were the most common foreign body found (44.3%). Radiologically, foreign bodies were highly suspicious in 51 cases (76.1%). Intraoperatively, thirty six cases (70.6%) were positive. From 16 cases (23.9%) with normal radiograph, 10 cases (62.5%) were found to have foreign bodies. Therefore the plain radiograph is helpful, but clinical presentation is more reliable to determine surgical removal under general anaesthesia.

Fulltext Paraneoplastic dermatomyositis: a 12-year retrospective review in the Department of Dermatology Hospital Kuala Lumpur

Tang MM, Thevarajah S

Med J Malaysia, 2010 Jun;65(2):138-42.

PMID: 23756799 MyJurnal

Adult-onset dermatomyositis has been found to be associated with underlying malignancies in up to 40% of patients. The aims of this study were to determine the demographic profile, the underlying cancer and outcome in patients with dermatomyositis. This was a retrospective review of 38 patients with dermatomyositis seen over a 12-year period in the Department of Dermatology, Kuala Lumpur Hospital. Of these, 18 (47.4%) had an associated underlying malignancy. The male to female ratio was 2:1. Ten patients (55.6%) were Chinese. The youngest patient encountered was 32 years old. Nasopharyngeal carcinoma (61.1%) was the most common malignancy in our study population. Tumour markers were not useful as the initial screening for malignancies. Thorough screening for malignancy is imperative in adult dermatomyositis especially those above 40 years old.

Fulltext A review of parotid tumours and their management: a ten-year-experience

Shashinder S, Tang IP, Velayutham P, Prepageran N, Gopala KG, Kuljit S, et al.

Med J Malaysia, 2009 Mar;64(1):31-3.

PMID: 19852317 MyJurnal

To review the demographics, management and outcome of patients undergoing parotidectomy at a tertiary center. A total of 76 patients who underwent parotidectomies from January 1996 to December 2005 at the ORL department of our center were reviewed. All clinical, operative, postoperative, histology data were gathered and reviewed. Fine-needle aspiration cytology (FNAC) was diagnostic in 90% of patients with a sensitivity of 76% and specificity of 96%. Twenty-one patients had malignant tumours and the rest had benign or inflammatory lesions. There were a total of 48 superficial and 28 total parotidectomies performed. Facial nerve palsy occurred in 30 (39%) patients with 4% permanent palsy and 35% temporary palsy. The recurrence rate of pleomorphic adenoma was 2.6%. FNAC and CT scan were performed prior to the surgery were useful guidance in planning the operation but clinical judgment is more important. The most common surgery performed was superficial parotidectomy and the most common cause was due to pleomorphic adenoma. The incidence of complications and recurrence of tumour are comparable to other international studies. Prior knowledge of anatomy and careful planning is needed to decrease the incidence of facial nerve palsy.

Fulltext Paroxysmal dyskinesia as an unusual and only presentation of subcortical white matter ischaemia: a report of two cases

Norlinah MI, Shahizon AM

Med J Malaysia, 2008 Dec;63(5):410-2.

PMID: 19803303 MyJurnal

Secondary paroxysmal dyskinesias (PxD) have been previously reported in patients with multiple sclerosis, lacunar infarcts, head trauma, metabolic disorders such as hyperglycaemia, hypocalcaemia, migraine and central nervous system (CNS) infections. The causative lesions typically involve the basal ganglia structures, medulla and rarely the spinal cord. We report two patients who presented with paroxysmal dyskinesias as the only manifestation of subcortical white-matter ischaemia. Patient 1 presented with 3-year history of paroxysmal kinesigenic dyskinesia (PKD) and patient 2 with 6-month history of paroxysmal nonkinesigenic dyskinesia (PNKD). All investigations, including CSF oligoclonal bands were negative, except for a brain MRI which showed multiple, non-enhancing subcortical white matter lacunar infarcts. Therefore, subcortical white matter ischaemia should also be included in the differential diagnosis of PxD.

Mineral and physichocemical characterization of cockle (Anadara granosa) shells as an alternative biomaterial for bone tissue engineering

Hazmi AJ, Zuki AB, Noordin MM, Jalila A, Norimah Y

Med J Malaysia, 2008 Jul;63 Suppl A:93-4.

PMID: 19025000

This study was conducted based on the hypothesis that mineral and physicochemical properties of cockle shells similarly resemble the properties of corals (Porites sp.). Hence, the mineral and physicochemical evaluations of cockle shells were conducted to support the aforementioned hypothesis. The results indicated that cockle shells and coral exoskeleton shared similar mineral and physicochemical properties.

Fulltext Correlation of computed tomography and nasal endoscopic findings in chronic rhinosinusitis

Shahizon AM, Suraya A, Rozmnan Z, Aini AA, Gendeh BS

Med J Malaysia, 2008 Aug;63(3):211-5.

PMID: 19248692 MyJurnal

This is a cross sectional study of 40 patients diagnosed with chronic rhinosinusitis using the Lanza Kennedy diagnostic criteria based on nasal endoscopy (NE), and on computer tomography (CT) of the paranasal sinuses. The purpose of the study is to demonstrate the effectiveness and limitations of CT, and NE in the assessment of chronic rhinosinusitis. This study shows that CT was superior in detecting OMC involvement, presence of concha bullosa, paradoxical turbinate and nasal septal deviation. NE was better at detecting polyps.

Fulltext The prognostic value of early follow-up computerized tomography of the brain in adult traumatic brain injury

Kiflie A, Alias NA, Abdul-Kareem MM, Mar W, Abdullah J, Naing NN

Med J Malaysia, 2006 Oct;61(4):466-73.

PMID: 17243525 MyJurnal

A total of 31 adult patients with moderate and severe head injury were assessed clinically on admission for Glasgow Coma Scale (GCS) and short test of mental status (STMS) on follow-up and compared to their initial and follow up CT scan. Good predictors were admission GCS, midline shift, volume of subdural haemorrhage in the initial CT scan of the brain as well as the presence of post-traumatic hydrocephalus, gliosis and site of gliosis in the follow-up CT scan. There was no direct correlation between the significant predictors on the first CT scan and the follow-up CT scan of the brain.

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