MyMedR

Jasmi AY, Rohaizak, Meah FA, Sulaiman BT

Med J Malaysia, 1998 Mar;53(1):109-11.

Acute suppurative thyroiditis in a 62 year old lady with enteric fever is reported. Plain radiography of the neck showed a distinct localised abscess cavity with air fluid level. A rare causative agent Salmonella typhi was isolated. Needle aspiration and antibiotics resulted in complete recovery.

Matched MeSH terms: Acute Disease

Fulltext Acute angle closure glaucoma resulting from myelodysplasia

Ang GS, Tey A, Ng WS, Subrayan V

Med J Malaysia, 2007 Aug;62(3):259-60.

PMID: 18246923

Patients with bleeding diatheses can present in a variety of clinical situations. When these patients manifest with ocular complications, their management can be challenging. We describe a case of acute angle closure glaucoma secondary to subretinal haemorrhage, with myelodysplasia as a predisposing factor.

Matched MeSH terms: Acute Disease

Fulltext Adult acute epiglottitis

Arumainathan UD, Siow SC, Subha ST

Med J Malaysia, 2002 Jun;57(2):240-1.

PMID: 24326662

Acute epiglotiitis is a disease of rapid onset and progression of symptoms and has been well described in children. The importance of being aware of this diagnosis is to prevent an acute upper airway obstruction that can be potentially fatal. Here we describe two cases of adult acute epiglottitis where the patients had severe symptoms of sorethroat but a normal looking oropharynx.

Matched MeSH terms: Acute Disease

Fulltext Management of acute intracerebral haemorrhage - an update

Law ZK, Appleton JP, Bath PM, Sprigg N

Clin Med (Lond), 2017 Apr;17(2):166-172.

PMID: 28365631 DOI: 10.7861/clinmedicine.17-2-166

Managing acute intracerebral haemorrhage is a challenging task for physicians. Evidence shows that outcome can be improved with admission to an acute stroke unit and active care, including urgent reversal of anticoagulant effects and, potentially, intensive blood pressure reduction. Nevertheless, many management issues remain controversial, including the use of haemostatic therapy, selection of patients for neurosurgery and neurocritical care, the extent of investigations for underlying causes and the benefit versus risk of restarting antithrombotic therapy after an episode of intracerebral haemorrhage.

Matched MeSH terms: Acute Disease

Stomatocytic elliptocytosis and 'neutrophil drumsticks' as a marker of stem cell engraftment

S-Abdul-Wahid F, Soon-Keng C

Br J Haematol, 2002 Mar;116(4):731.

PMID: 11886374

Matched MeSH terms: Acute Disease

Fulltext Anterior praecordial ST-segment elevation

Liao CM, Soo CS

Singapore Med J, 1996 Feb;37(1):101, 122-3.

PMID: 8783924

Matched MeSH terms: Acute Disease

Adenovirus type 21-associated acute flaccid paralysis during an outbreak of hand-foot-and-mouth disease in Sarawak, Malaysia

Ooi MH, Wong SC, Clear D, Perera D, Krishnan S, Preston T, et al.

Clin Infect Dis, 2003 Mar 1;36(5):550-9.

PMID: 12594634

We report the virological and clinical features of 8 children who presented with adenovirus-associated acute flaccid paralysis (AFP) during an epidemic of enterovirus type 71 (EV71)-associated hand-foot-and-mouth disease (HFMD) in Sarawak, Malaysia, in 1997. Neutralization tests and phylogenetic analysis revealed adenovirus type 21 (Ad21), although DNA restriction digests suggested that this virus was different from the prototype Ad21. Four children had upper-limb monoparesis, 2 had lower-limb monoparesis (one of whom had changes in the anterior spinal cord noted on magnetic resonance imaging), and 2 had flaccid paraparesis. At follow-up, 4 children were noted to have made full recoveries and 3 had residual flaccid weakness and wasting. Neurophysiological investigation revealed a mixture of axonal and demyelinating features in motor and sensory nerves, with denervation. These findings suggest that Ad21 might cause AFP by anterior horn cell damage or neuropathy of the brachial or lumbosacral plexus. The occurrence of these unusual adenovirus infections during an outbreak of EV71-associated HFMD suggests that an interaction between the 2 viruses may have occurred.

Matched MeSH terms: Acute Disease

Fulltext Evaluation of two commercially available ELISAs for the diagnosis of Japanese encephalitis applied to field samples

Lewthwaite P, Shankar MV, Tio PH, Daly J, Last A, Ravikumar R, et al.

Trop Med Int Health, 2010 Jul;15(7):811-8.

PMID: 20487425 DOI: 10.1111/j.1365-3156.2010.02537.x

OBJECTIVE: To compare two commercially available kits, Japanese Encephalitis-Dengue IgM Combo ELISA (Panbio Diagnostics) and JEV-CheX IgM capture ELISA (XCyton Diagnostics Limited), to a reference standard (Universiti Malaysia Sarawak - Venture Technologies VT ELISA).

METHODS: Samples were obtained from 172/192 children presenting to a site in rural India with acute encephalitis syndrome.

RESULTS: Using the reference VT ELISA, infection with Japanese encephalitis virus (JEV) was confirmed in 44 (26%) patients, with central nervous system infection confirmed in 27 of these; seven patients were dengue seropositive. Of the 121 remaining patients, 37 (31%) were JEV negative and 84 (69%) were JEV unknown because timing of the last sample tested was <10 day of illness or unknown. For patient classification with XCyton, using cerebrospinal fluid alone (the recommended sample), sensitivity was 77.8% (59.2-89.4) with specificity of 97.3% (90.6-99.2). For Panbio ELISA, using serum alone (the recommended sample), sensitivity was 72.5% (57.2-83.9) with specificity of 97.5% (92.8-99.1). Using all available samples for patient classification, sensitivity and specificity were 63.6% (95% CI: 48.9-76.2) and 98.4% (94.5-99.6), respectively, for XCyton ELISA and 75.0% (59.3-85.4) and 97.7% (93.3-99.2) for Panbio ELISA.

CONCLUSION: The two commercially available ELISAs had reasonable sensitivities and excellent specificities for diagnosing JEV.

Matched MeSH terms: Acute Disease

Cytogenetic abnormalities in de novo acute myeloid leukemia in adults: relation to morphology, age, sex and ethnicity - a single center study from Singapore

Enjeti AK, Tien SL, Sivaswaren CR

Hematol. J., 2004;5(5):419-25.

PMID: 15448668

Cytogenetic analysis performed at diagnosis is considered to be the most valuable prognostic factor in acute myeloid leukemia (AML). Large systematic studies of cytogenetic abnormalities in AML patients from Southeast Asia are not available. The karyotypic patterns in AML patients from a single center in Singapore were studied and compared with reports from other regions of the world to identify possible geographic heterogeneity.

Matched MeSH terms: Acute Disease

The acute abdomen and the obstetrician

Sivanesaratnam V

Baillieres Best Pract Res Clin Obstet Gynaecol, 2000 Feb;14(1):89-102.

PMID: 10789262

An acute abdomen in pregnancy can be caused by pregnancy itself, be predisposed to by pregnancy or be the result of a purely incidental cause. These various conditions are discussed. The obstetrician often has a difficult task in diagnosing and managing the acute abdomen in pregnancy. The clinical evaluation is generally confounded by the various anatomical and physiological changes occurring in pregnancy itself. Clinical examination is further hampered by the gravid uterus. The general reluctance to use conventional X-rays because of the pregnancy should be set aside when faced with the seriously ill mother. A reluctance to operate during pregnancy adds unnecessary delay, which increases morbidity for both mother and fetus. Such mistakes should be avoided as prompt diagnosis and appropriate therapy are crucial. A general approach to acute abdominal conditions in pregnancy is to manage these problems regardless of the pregnancy.

Matched MeSH terms: Acute Disease

Autoimmune thrombocytopenia and neutropenia after autologous peripheral blood stem cell transplantation

Wahid FS, Cheong SK, Sivagengei K

Acta Haematol., 2002;107(4):237-8.

PMID: 12053154

Matched MeSH terms: Acute Disease

Fulltext Quantitation of T lymphocyte subsets helps to distinguish dengue hemorrhagic fever from classic dengue fever during the acute febrile stage

Fadilah SA, Sahrir S, Raymond AA, Cheong SK, Aziz JA, Sivagengei K

Southeast Asian J. Trop. Med. Public Health, 1999 Dec;30(4):710-7.

PMID: 10928365

Activation of immunoregulatory T lymphocyte subsets has been observed in dengue viral infection, being more evident in dengue hemorrhagic fever (DHF) than in classical dengue fever (DF). There are, however, as yet no well-defined host markers to determine which patients with dengue viral infection will develop severe complications during the acute febrile stage of the disease. A study was performed to compare the cellular immune status in DHF, DF and non-dengue viral infections (NDF) in order to determine the value of these parameters in distinguishing DHF from classic DF and other viral infections during the acute febrile stage of the disease. This study involved 109 febrile patients admitted because of suspected DHF. Fifty patients were serologically confirmed cases of dengue infection, of which 25 had grade 1 or 2 DHF. There was a reduction in total T (CD3), CD4 and CD8 cells in DHF and demonstrated that a low level of CD3, CD4, CD8 and CD5 cells discriminated DHF from DF patients during the febrile stage of the illness. In contrast, B (CD19) cells and natural killer (NK) cells did not appear to be discriminatory in this study. Receiver operating characteristic (ROC) curve analysis showed that a combination of CD3 cell of < or = 45% and CD5 cell of < or = 55% was the best marker to identify DHF patients (sensitivity = 84% and specificity = 52% for CD3 cell of < or = 45%; sensitivity = 92% and specificity = 71% for CD5 cell of < or = 55%). CD4 cell of < or = 25% and CD8 cell < or = 30% were equally good in discriminating DHF from DF patients. On the other hand, the ROC curves indicated no clear difference between the immunoregulatory cell counts in DF from NDF Lymphopenia, atypical lymphocytosis and thrombocytopenia were significantly more evident in dengue compared to non-dengue infection but did not appear to be discriminatory among DHF and DF patients. The reduction in CD3, CD4, CD8, CD5 cells correlated with the degree of thrombocytopenia in DHF (p < 0.05) which suggests that these cells probably participate in a common pathogenetic mechanism.

Matched MeSH terms: Acute Disease

Acute septicemic melioidosis occurring in a child with acute lymphoblastic leukemia

Lin HP, Puthucheary SD, Sinniah D

Clin Pediatr (Phila), 1980 Oct;19(10):697-9.

PMID: 6931670

A 13-year old boy with acute lymphoblastic leukemia on chemotherapy developed neutropenia and acute cellulitis progressing to fulminating septicemia due to Pseudomonas pseudomallei. Septicemic melioidosis should be considered in the differential diagnosis of a febrile illness in children who are susceptible to infections.

Matched MeSH terms: Acute Disease

Fulltext Blood pressure in acute intracerebral haemorrhage

Rasool AH, Rahman AR, Choudhury SR, Singh RB

J Hum Hypertens, 2004 Mar;18(3):187-92.

PMID: 14973513 DOI: 10.1038/sj.jhh.1001647

Stroke is one of the leading causes of death worldwide, and spontaneous bleeding into the brain parenchyma, intracerebral haemorrhage (ICH), is a stroke subtype associated with high morbidity and mortality. Overall, it comprises about 15% of all stroke in Caucasians, this figure being much higher in Asians and black people. Blood pressure (BP) appears to play an important role in this disease. We have reviewed available literature on the relationship of BP to the occurrence of primary and secondary ICH, the association of BP levels measured early after stroke with prognosis and complications, and evidence about the effects of early BP lowering treatments on post-stroke outcomes. BP appears to be an important risk factor for primary and secondary ICH. In addition, high BP early after ICH may be detrimental to outcome, possibly contributing to complications such as rebleeding and haematoma enlargement. Few data are available about the effects of early lowering of BP on outcome after ICH with no reliable trial yet conducted. Proper randomised trials are required to establish the effect of early lowering of BP on outcome after ICH.

Matched MeSH terms: Acute Disease

Fulltext Acute appendicitis and the leucocyte count

Singh KJ

Med J Malaysia, 1980 Mar;34(3):314-6.

PMID: 7412672

The total and differential leucocyte counts were estimated in 100 consecutive cases operated for acute appendicitis. Leucocytosis was seen in 52% of cases. 480/0 of patients had a leucocyte count below 10000 per c. mm. A study of the differential count was also made to see if this parameter could be used as a specific diagnostic aid. Though the neutrophil count was high in 74% of the cases, the comparative count among the below 10000 per c.mm. group was not significant. It is concluded that the total and differential counts are of limited value in the assessment of these patients. It is suggested that such estimation be used as a supportive aid only. In those doubtful cases with normal or low counts, frequent clinical reviews should be done and reliance placed on clinical assessment rather than laboratory information.

Matched MeSH terms: Acute Disease

An unusual presentation of acute cholecystitis: biliary ascariasis

Amjad N, Nor AM, Singh H

Hosp Med, 2001 Jun;62(6):370-1.

PMID: 11436449

Matched MeSH terms: Acute Disease

Fulltext Managing congestive heart failure in a general hospital in Malaysia. Are we keeping pace with evidence?

Chin SP, Sapari S, How SH, Sim KH

Med J Malaysia, 2006 Aug;61(3):278-83.

PMID: 17240575 MyJurnal

Evidence-based heart failure management now includes beta-blockers and spironolactone in addition to diuretics and angiotensin-converting enzyme inhibitors. We aim to determine if these recommendations had been applied in practice for acute and chronic stable heart failure, and what difficulties there might be. Data from 80 consecutive patients hospitalized for decompensated heart failure ('acute') between May and July 2003 were analyzed at admission, upon discharge and at 12 weeks follow-up; along with 74 cardiology clinic out-patients with stable congestive heart failure ('chronic'- no decompensation or admission in previous six months). Less than half of study patients with prior left ventricular dysfunction were on ACE-inhibitors (47%), diuretics (39%), ATII antagonists, spironolactone or digoxin (5% each). All 'acute' patients were commenced on diuretics and ACE-inhibitors in hospital. Six patients died or transferred to another center. Compliance with clinic appointment at 12 weeks was 85% despite telephone reminders. Drug prescription at 12 weeks was significantly lower for diuretics and ACE-inhibitors compared to prescription at discharge (all p < 0.05) but higher compared to patients with chronic HF. Diuretics and ACE inhibitors remain under-utilized for patients with recurrent heart failure. Use of spironolactone and beta-blocker is slow due to limited medical experience and funding. Clinic non-attendance is significant and due to patient factors.

Matched MeSH terms: Acute Disease

Vessel density ratio: A novel approach to identify "culprit" coronary lesion by spiral computed tomography

Chin BS, Ong TK, Seyfarth TM, Liew CK, Chan WL, Rapaee A, et al.

J Comput Assist Tomogr, 2006 7 18;30(4):564-8.

PMID: 16845284

BACKGROUND AND OBJECTIVE: We hypothesized that a "culprit" lesion in acute coronary syndrome (ACS) should have low overall vessel lumen and plaque density on multidetector computed tomography-assisted coronary angiography (MDCTA) because of lower calcification and the presence of occlusive thrombus. However, thrombi and calcification both can themselves blur the demarcation between vessel wall and lumen. If we calculated a "vessel density ratio" (VDR) obtained by measuring the mean density of contrast-enhancement within a region of interest (ROI), which includes the vessel wall, lumen, plaque, and thrombus, and comparing that with the aortic root mean density acting as a reference point, this ratio may be more convenient, standardized, and reproducible to test the feasibility of VDR in identifying "culprit" lesions in ACS.

METHODS: Sixty-four patients-21 exertional angina; 17 unstable angina/non-ST elevation myocardial infarction (NSTEMI); 26 ST elevation myocardial infarction (STEMI)-provided 188 diseased segments on conventional angiography. All underwent MDCTA within a week of angiography. ROI was mapped out from maximum intensity projections of diseased segments in planar view.

RESULTS: One hundred seventy-four segments were evaluated. Patients who presented with ACS (STEMI and unstable angina/non-ST elevation myocardial infarction) had lower mean VDR compared to patients with exertional angina (0.58 vs. 0.66 vs. 0.81; P < 0.001). Culprit lesions in ACS patients also had the lowest mean VDR when compared to nonculprit lesions and lesions in patients without ACS (0.51 vs. 0.68 vs. 0.81; P < 0.001).

CONCLUSIONS: VDR is a new, convenient, and standardized approach in identifying "culprit" lesions by MDCTA.

Matched MeSH terms: Acute Disease

Fulltext Universal Recommendations for the Management of Acute Diarrhea in Nonmalnourished Children

Guarino A, Lo Vecchio A, Dias JA, Berkley JA, Boey C, Bruzzese D, et al.

J Pediatr Gastroenterol Nutr, 2018 11;67(5):586-593.

PMID: 29901556 DOI: 10.1097/MPG.0000000000002053

OBJECTIVE: Despite a substantial consistency in recommendations for the management of children with acute gastroenteritis (AGE), a high variability in clinical practice and a high rate of inappropriate medical interventions persist in both developing and developed countries.The aim of this study was to develop a set of clinical recommendations for the management of nonseverely malnourished children with AGE to be applied worldwide.

METHODS: The Federation of International Societies of Pediatric Gastroenterology, Hepatology, and Nutrition (FISPGHAN) Working Group (WG) selected care protocols on the management of acute diarrhea in infants and children aged between 1 month and 18 years. The WG used a 3-step approach consisting of: systematic review and comparison of published guidelines, agreement on draft recommendations using Delphi methodology, and external peer-review and validation of recommendations.

RESULTS: A core of recommendations including definition, diagnosis, nutritional management, and active treatment of AGE was developed with an overall agreement of 91% (range 80%-96%). A total of 28 world experts in pediatric gastroenterology and emergency medicine successively validated the set of 23 recommendations with an agreement of 87% (range 83%-95%). Recommendations on the use of antidiarrheal drugs and antiemetics received the lowest level of agreement and need to be tailored at local level. Oral rehydration and probiotics were the only treatments recommended.

CONCLUSIONS: Universal recommendations to assist health care practitioners in managing children with AGE may improve practitioners' compliance with guidelines, reduce inappropriate interventions, and significantly impact clinical outcome and health care-associated costs.

Matched MeSH terms: Acute Disease

The goat as a model for studies of pneumonic pasteurellosis caused by Pasteurella multocida

Zamri-Saad M, Effendy WM, Maswati MA, Salim N, Sheikh-Omar AR

Br. Vet. J., 1996 Jul;152(4):453-8.

PMID: 8791853

A model of pneumonic pasteurellosis has been established in goats using Pasteurella multocida harvested from pneumonic lungs of goats (types A and D), rabbits (type A) and sheep (type D). The resultant infections were acute, subacute or chronic. The gross and histological lesions of the subacute and chronic infections were typical of pneumonic pasteurellosis. P. multocida type D produced significantly (P < 0.01) more severe lesions when compared with other isolates. There were strong correlations between the clinical signs and the severity of lesions.

Matched MeSH terms: Acute Disease

Displaying publications 61 - 80 of 361 in total