MyMedR

The quality of life among coronary heart disease patients at a teaching hospital

Ho SE, Ting CK, Das S, Loo CY, Rohayu AB, Khor SY, et al.

Clin Ter, 2011;162(3):217-22.

Quality of life after acute coronary heart disease amongst patients is important outcome factor in deliberations of patient's care. The main aim of the study was to examine the quality of life amongst acute CHD patients.

Does gamma irradiation affect physicochemical properties of honey?

Hussein SZ, Yusoff KM, Makpol S, Mohd Yusof YA

Clin Ter, 2014;165(2):e125-33.

PMID: 24770820 DOI: 10.7471/CT.2014.1695

Honey is a supersaturated solution of sugars, enriched with proteins, minerals, vitamins, organic acids and polyphenols. Gamma irradiation is a physical technique of food preservation which protects the honey from insects' and microbial contamination during storage. We investigated the effect of gamma irradiation on physicochemical properties in two types of Malaysian honey, Gelam and Nenas.

Calcium score of coronary artery stratifies the risk of obstructive coronary artery diseases

Ibrahim O, Oteh M, Anwar IR, Che Hassan HH, Choor CK, Hamzaini AH, et al.

Clin Ter, 2013;164(5):391-5.

PMID: 24217823 DOI: 10.7417/CT.2013.1601

Coronary heart disease is a major health problem in Malaysia with high morbidity and mortality. Common primary screening tool of cardiovascular risk stratification is exercise treadmill test (ETT). This communication is to determine the performance of coronary artery calcium score a new method to stratify the presence of obstructive coronary artery disease (CAD) in comparison to traditional ETT in patients having coronary artery diseases.

Off-pump Coronary artery bypass graft surgery in patients with left main stem disease

Ishamuddin IM, Zamrin DM, Joanna OS, Ramzisham AR, Hairolfaizi H

Clin Ter, 2011;162(6):527-31.

PMID: 22262322

The safety, feasibility and post-operative outcome are the main concern in Off-pump Coronary artery bypass graft (OPCAB) surgery as compared to conventional technique especially in multi-vessels coronary artery disease.

Study on advanced life support devices in the ambulances for emergency cases in Klang Valley, Malaysia

Ismail MS, Hasinah AB, Syaiful MN, Murshidah HB, Thong TJ, Zairi Z, et al.

Clin Ter, 2012;163(2):115-22.

PMID: 22555825

In an effort to improve pre-hospital care, the authors assessed the availability and utility of ambulance devices. The study aimed to identify commonly used devices for managing emergency cases in Klang Valley of Malaysia.

Myocardial ischaemic time and its relation with left ventricular ejection fraction after single valve replacement

Izham IN, Zamrin DM, Joanna OS, Ramzisham AR, Hairolfaizi H, Ishamuddin IM, et al.

Clin Ter, 2011;162(6):521-5.

PMID: 22262321

The effect of the duration of ischaemic myocardial time to left ventricular ejection fraction (LVEF) after valve replacement surgery has been attributed. This study aims to look at the correlation between myocardial ischaemic time and changes LVEF post valve replacement surgery up to 6 months period.

Enzymatic and microstructural changes in the liver of experimental rats fed with fatty diet and fresh or heated soy oil concurrently

Jaarin K, Hwa TC, Umar NA, Siti Aishah MA, Das S

Clin Ter, 2010;161(5):429-33.

PMID: 21057734

Consumption of heated edible oils may be harmful. The present study aimed to observe the histological changes due to concurrent consumption of soy oil (either fresh or heated) and fatty diet and the changes in the level of alanine transaminase (ALT) and alkaline phosphatase (ALP).

Resolution of Acanthosis Nigricans Following Curative Gastric Carcinoma Resection

Jagwani AV, Reynu R, Affirul CA, Mustafa MT, Kosai NR

Clin Ter, 2016;167(4):99-100.

PMID: 27598021 DOI: 10.7417/CT.2016.1937

We discuss a 48-year old, who presented with upper epigastrium pain associated with early satiety and significant weight loss. Physical examination revealed a thickening and darkening of skins around the skin folds, scalp, back and front of abdomen. A diagnosis of gastro-esophageal junction adenocarcinoma was confirmed by oesophagogastroduodenoscopy (OGDS) and biopsy. The biopsy of the skin lesion revealed a diagnosis of acanthosis nigricans, He underwent a total gastrectomy followed by adjuvant chemo-radiotherapy. Recovery is unremarkable. Interestingly, the skin lesions disappear following our therapy. We believe this may be attributed to the treatment of the malignancy. We highlight the interesting association, pathophysiology and therapy.

Transarterial angioembolization versus surgery after failed endoscopic therapy for non-variceal upper gastrointestinal bleeding

Jailani RF, Kosai NR, Yaacob NY, Jarmin R, Sutton P, Harunarrashid H, et al.

Clin Ter, 2014;165(6):294-8.

PMID: 25524184 DOI: 10.7417/CT.2014.1771

BACKGROUND AND OBJECTIVE: To compare the outcome of transarterial angioembolization (TAE) and surgery with endoscopically unmanageable non-variceal hemorrhage of the upper gastrointestinal tract.

MATERIALS AND METHODS: A case note review of all patients treated for non-variceal upper gastrointestinal bleeding from January 2006 till January 2012 was performed.

RESULTS: Fifty-four of 667 patients with non-variceal bleeding did not respond to endoscopic treatment. Nine of the 54 patients had incomplete data, leaving 45 patients in the study; 24 had angiography and another 21 had surgery. The two groups were broadly similar in terms of relevant clinical variables. Nineteen of 24 having angiography had embolisation. Re-bleeding recurred in 8 patients (33%) in the TAE group and 6 patients (28.6%) in the surgery group (p = 0.28). There was no statistically significant difference in post procedural complications (81% vs 62.5%, p = 0.17), 30-day mortality (33% vs 29.1%, p = 0.17 ) units of blood transfused (12.24 vs 8.92, p = 0.177) and mean hospital stay (30.7 vs 22.9 days, p = 0.281) observed in patients undergoing surgery as compared to TAE.

CONCLUSIONS: TAE and surgery have similar outcomes in patients with endoscopically unmanageable non-variceal upper gastrointestinal haemorrhage.

The effect of Piper betel extract on the wound healing process in experimentally induced diabetic rats

Keat EC, Razak SS, Fadil NM, Yusof FM, Chan LH, Chyi FK, et al.

Clin Ter, 2010;161(2):117-20.

PMID: 20499023

Piper betel (PB) possesses antimicrobial, antifungal, antioxidant and wound healing properties due to its powerful antioxidant effect. Diabetes mellitus (DM) is a metabolic disorder which is associated with complications like impaired wound healing, nephropathy and neuropathy. The main aim of the study was to study the wound healing properties of PB.

Tocotrienol-rich fraction prevents cellular aging by modulating cell proliferation signaling pathways

Khor SC, Mohd Yusof YA, Wan Ngah WZ, Makpol S

Clin Ter, 2015;166(2):e81-90.

PMID: 25945449 DOI: 10.7417/CT.2015.1825

BACKGROUND AND OBJECTIVE: Vitamin E has been suggested as nutritional intervention for the prevention of degenerative and age-related diseases. In this study, we aimed to elucidate the underlying mechanism of tocotrienol-rich fraction (TRF) in delaying cellular aging by targeting the proliferation signaling pathways in human diploid fibroblasts (HDFs).

MATERIALS AND METHODS: Tocotrienol-rich fraction was used to treat different stages of cellular aging of primary human diploid fibroblasts viz. young (passage 6), pre-senescent (passage 15) and senescent (passage 30). Several selected targets involved in the downstream of PI3K/AKT and RAF/MEK/ERK pathways were compared in total RNA and protein.

RESULTS: Different transcriptional profiles were observed in young, pre-senescent and senescent HDFs, in which cellular aging increased AKT, FOXO3, CDKN1A and RSK1 mRNA expression level, but decreased ELK1, FOS and SIRT1 mRNA expression level. With tocotrienol-rich fraction treatment, gene expression of AKT, FOXO3, ERK and RSK1 mRNA was decreased in senescent cells, but not in young cells. The three down-regulated mRNA in cellular aging, ELK1, FOS and SIRT1, were increased with tocotrienol-rich fraction treatment. Expression of FOXO3 and P21Cip1 proteins showed up-regulation in senescent cells but tocotrienol-rich fraction only decreased P21Cip1 protein expression in senescent cells.

CONCLUSIONS: Tocotrienol-rich fraction exerts gene modulating properties that might be responsible in promoting cell cycle progression during cellular aging.

Laparoendoscopic Transgastric Enucleation of an awkwardly sited Peri-Cardial Gastrointestinal Stromal Tumour (GIST): A Multi- Modal Approach

Kosai NR, Rajan R, Roslani EJ, Sutton PA, Mustafa M, Das S

Clin Ter, 2015 Nov-Dec;166(6):248-52.

PMID: 26794812 DOI: 10.7417/CT.2015.1896

In the modern era of surgery, minimally invasive surgery is increasingly applied for excision of gastrointestinal stromal tumors. Site, size and tumor location are important factors that affect the surgical approach and excision. We performed a laparoendoscopic transgastric enucleation of a 4-cm pericardial endophytic gastrointestinal stromal tumor (GIST) using an energy device. The surgery was successful and post-operative recovery uneventful. No tumor recurrence was detected on surveillance gastroscopy. In the safe hands of a well-trained laparoscopic upper gastrointestinal surgeon, pericardial GIST can be enucleated safely by this method. The avoidance of surgical staplers is not only cost-effective, but also reduces the risk of associated complications.

Pregnant and severe acute abdominal pain: A surgical diagnostic dilemma

Kosai NR, Amin-Tai H, Gendeh HS, Salleh S, Reynu R, Taher MM, et al.

Clin Ter, 2015;166(3):110-3.

PMID: 26152617 DOI: 10.7417/CT.2015.1839

Acute abdominal pain in pregnancy remains a surgical conundrum. A 25-year-old primigravid at 29 weeks gestation presented with a two-week history of epigastric pain, nausea and vomiting. She had a distended abdomen consistent with a full term gravid uterus; tender at the epigastric and right hypochondrium suggestive of small bowel obstruction or acute appendicitis. Abdominal ultrasound was inconclusive but abdominal Computed Tomography (CT) suggested small bowel volvulus. An exploratory laparotomy revealed a segmental jejunal volvulus and small bowel diverticulum contributing to the volvulus. A short segmental bowel resection was performed. Histopathology confirmed a Meckel's Diverticulum. The patient recovered well but underwent premature labour 10 days later. Small bowel obstruction secondary to Meckel's diverticulum is rare in pregnancy. In an acute gestational abdomen, clinical examination is key. Radiological imaging may be helpful, whilst surgical intervention is confirmatory and therapeutic in the event of an obstructive volvulus.

The harmful effects of consumption of repeatedly heated edible oils: a short review

Ku SK, Muhamad Ruhaifi MS, Fatin SS, Saffana M, Taty Anna K, Das S, et al.

Clin Ter, 2014;165(4):217-21.

PMID: 25203337 DOI: 10.7417/CT.2014.1737

It has been a regular practice to repeatedly heat the cooking oil and consume it without knowing the harmful effects of such. The procedure to use repeatedly heated cooking oil is aimed to curb the cost of expenses. Heating results is the formation of free reactive oxygen species (ROS) which is responsible for the oxidative stress and damage to various organs in the body. The present review article discusses the harmful events occurring due to consumption of repeated heating of edible oil. A strong message is aimed to generate public awareness of the deleterious effects of consumption of heated edible oil which may help in curbing hypertension and atherosclerosis.

Rare atypical vascular pattern of subscapular artery: Anatomico-clinical insight

Kumar A, Goel S, Arora J, Mehta V, Pakhiddey R, Suri RK, et al.

Clin Ter, 2015;166(3):118-20.

PMID: 26152619 DOI: 10.7417/CT.2015.1841

The use of muscles of scapular region in transposition and reparative surgery has made the anatomical knowledge of axillary artery and its branches imperative. The subscapular arterial tree is frequently used as a source of microvascular grafts to replace damaged or diseased portion of arteries especially in upper and lower limbs. This investigation is aimed to study the variation in branching pattern of the third part of axillary artery.

Fulltext Ultrasound Probe Positions for Internal Jugular Vein Cannulation: A Prospective Study of Different Techniques

Kurien M, Teo R, Zainuddin K, Azidin AM, Izaham A, Budiman M, et al.

Clin Ter, 2021 Jul 05;172(4):278-283.

PMID: 34247211 DOI: 10.7417/CT.2021.2332

Objective: We compared sonoanatomy of the internal jugular vein (IJV) the high (HA), conventional (CA) and the medial oblique approach (MA) to identify the best approach and head position for IJV cannulation.

Materials & Methods: Total of 45 volunteers aged 18-65 years were included in this study. The degree of overlap in percentage, depth of IJV from skin, antero-posterior (AP) and transverse diameters (TD) of IJV were measured in real time with ultrasound (US). Measurements were taken in the HA, CA and MA in neutral and 30° head rotation on both the right and left side of the neck.

Results: The HA had lower percentage of overlap when compared to CA and MA in neutral and 30° head rotation (p= 0.002 to ≤0.001). The IJV was more shallow in the CA and MA. The AP and TD of the IJV were larger in the MA when compared to HA (p=<0.001) and CA (p =0.026 to < 0.001) and the right IJV has a larger AP and TD in all approaches.

Discussion: The HA had the least percentage of overlap compared to CA and MA, therefore the risk of accidental ICA puncture can be reduced. The apparent overlap seen in MA may not reflect the actual scenario because of the way the US beam cuts the vessel. The AP and TD of IJV were significantly increased in the MA, which would ease CVC.

Conclusion: We conclude and recommend the medial oblique probe position with 30° head rotation provides optimal real time sonographic parameters for US guided IJV cannulation.

Wound healing in diabetes mellitus: traditional treatment modalities

Laitiff AA, Teoh SL, Das S

Clin Ter, 2010;161(4):359-64.

PMID: 20931161

The healing of wound is a complex process which requires the interactions of different cells and extracellular molecules. The normal wound healing process can be divided into four overlapping phases i.e. haemostasis, inflammation, proliferation and remodeling. In diseased condition like diabetes mellitus, the wound healing process is grossly impaired, resulting in chronic wounds which fail to heal. In the past decades, several researchers have tested various traditional medicines obtained from the plants for their wound healing properties. Such traditional plants are Aloe vera, Calotropis procera, Portulaca oleracea, Acalypha langiana, Plagiochasma appendiculatum and Momordica charantia. Perhaps one of the most popular and easily available plant is Momordica charantia (bitter gourd). The present article presents an extensive review on the impaired wound healing process in diabetes mellitus and highlights the use of traditional medicines in diabetic wounds.

Test of Sex Estimation Equations on Carpal Bones in a Northeastern Thai Population

Laowatthanaphong S, Das S, Phatsara M, Tuamsuk P, Mahakkanukrauh P

Clin Ter, 2016 Mar-Apr;167(2):29-32.

PMID: 27212569 DOI: 10.7417/CT.2016.1917

Sex assessment is an essential step in person identification, both in forensic and anthropological contexts. Many parts of skeletal remains such as skull, pelvis and long bones have been proven to be useful in determining sex. However, literature has shown that short bones such as carpal bones are also sexually dimorphic. In the last few years, there was an unpublished study using lunate, scaphoid and hamate from bone collection in Northern Thailand to create 6 discriminant equations to assess sex. The objective of this study was to investigate the application of those equations in the sample from other parts of Thailand.

Fulltext Autogenous free fat graft combined with platelet-rich fibrin heals a refractory mandibular osteoradionecrosis

Law B, Mohd Yunus SS, Ramli R

Clin Ter, 2020 3 7;171(2):e110-e113.

PMID: 32141481 DOI: 10.7417/CT.2020.2199

Osteoradionecrosis (ORN) is a well-recognized, debilitating complication of radiotherapy for patients with head and neck cancer. There is no universally accepted treatment for ORN of the jawbones. We report on a case of refractory mandibular ORN treated by sequestrectomy of mandible and autogenous transplantation of fat graft combined with platelet-rich fibrin (PRF). Improved perfusion was observed using the laser Doppler flowmetry. This case highlights the use of autogenous free fat graft and PRF as an adjunct therapy to sequestrectomy in the management of ORN.

A review of the use of Piper betel in oxidative stress disorders

Lee CY, Nurul Zaidah AS, Nur Amalina G, Muhammad Azree E, Das S, Zar CT

Clin Ter, 2014;165(5):269-77.

PMID: 25366948 DOI: 10.7417/CT.2014.1758

Increase in prevalence of disease related oxidative stress disorders have been on the rise in the entire world since the past decades. Significant positive effects with few antioxidant properties in the modern drugs pave for the alternative medicines in managing the disease. Piper betel (P. betel), a herb, is known to possess high anti-oxidant, anti-diabetic, anti-atherosclerosis, anti-hyperlipidemic, anti-cancer and neuroprotective property. This review focused on the effect of P. betel on diabetes mellitus, atherosclerosis and chronic kidney disease, Alzheimer's disease and breast cancer. P. betel proved to show positive effects with specific outcomes towards these diseases. Moreover, the promising effect of P. betel in vitro studies was also highlighted in the present review. It is believed that the findings obtained in this review will draw the attention of the medical professionals and general public towards P. betel and it will open the door for further detailed research.

Displaying publications 61 - 80 of 159 in total