MyMedR

Fulltext Percutaneous transpedicular biopsy of the spine

Chooi YS, Kamil OI, Fazir M, Kob SC

Med J Malaysia, 2007 Mar;62(1):46-8.

An open biopsy has minimal sampling error, but is a major procedure, with its inherent complications and morbidity. The complications of paraspinal needle biopsy of vertebral lesions are well known. Needle biopsies have a high incidence of false negatives, especially for tumors. Percutaneous transpedicular bopsy is efficacious, safe, and cost effective, and mostly performed under local anesthesia. Fluoroscopic monitoring enables real time positioning of the needle. Serious needle complications from percutaneous needle biopsy are uncommon. More than 50% of vertebral body tissue, including the disc is accessible via a unilateral transpedicular approach and amenable for biopsy.

Matched MeSH terms: Middle Aged

Fulltext Changing approaches in HIV testing

Lee CK

Med J Malaysia, 2007 Mar;62(1):1-2.

PMID: 17682559 MyJurnal

In 1985, when HIV testing first became available, the main goal of such testing was to ensure blood safety. Hemophiliacs and other patients who were transfusion-dependent were the initial patients that needed to be protected as they were exposed to iatrogenic risk. It dawned very quickly to health authorities even then that alternative testing sites had to be quickly established to deter persons from using blood bank facilities for HIV testing purposes. At that time, professional opinion was divided regarding the value of HIV testing and whether HIV testing should be encouraged because no consensus existed regarding whether a positive test predicted transmission to sex partners or from mother to infant. No effective treatment existed then and stigma and discrimination faced by those who were found positive was rampant in many parts of the world. Counseling was designed, in part, to ensure that persons tested were aware of the implications of a positive result and in part, to address the person’s risk behavior to reduce transmission to others.

Matched MeSH terms: Middle Aged

Fulltext Endoscopic assisted transseptal transphenoidal hypophysectomy

Mallina S, Harvinder S, Rosalind S, Philip R, Gurdeep S, Anil S

Med J Malaysia, 2006 Aug;61(3):320-2.

PMID: 17240583 MyJurnal

Eight patients with pituitary tumors were operated via the transseptal transsphenoidal approach from April to November 2004 at Hospital Ipoh. Seven patients presented with visual disturbances while three also had endocrine abnormalities. The post-operative follow-up period was between six months to a year. There was no mortality in this series. There were no complications related to the approach i.e. nasal or septal related. All patients with visual impairment showed improvement. Only one patient had hormonal irregularities. The endoscopic assisted transseptal approach to the sphenoid sinus for pituitary surgery was found to be easy and without sinonasal or labial complications often found with the sublabial approach.

Matched MeSH terms: Middle Aged

Fulltext Early outcome of reamed interlocking nail for non-union of tibia

Faisham WI, Sulaiman AR, Sallehuddin AY, Zuhmi W

Med J Malaysia, 2006 Aug;61(3):339-42.

PMID: 17240586 MyJurnal

Aseptic non-union is a major problem following complicated fracture tibia, which carries significant morbidity and prolonged course of treatment. Plate fixation and autogenous bone grafting has been established as a method of treatment. However the risk of infection, implant failure and donor site morbidity are high. We reviewed twelve consecutive cases of established non-union tibia treated by closed reamed interlocking nail in our centre. All patients had clinical and radiological union at three months. Three patients were complicated with infection and one required removal of implant and re-reaming to eradicate infection. Reamed interlocking nailing is an alternative treatment for selected non-union of fracture tibia with promising results.

Matched MeSH terms: Middle Aged

Fulltext Perioperative mortality review in relation to pregnancy-related deaths

Achanna KS, Zaleha AM, Sachchithanantham, Farouk AM

Med J Malaysia, 2006 Aug;61(3):312-9.

PMID: 17240582 MyJurnal

Pregnancy-related deaths in four published perioperative mortality review reports were analysed. The aim is to look at the quality of surgical and anaesthetic services along with the perioperative care provided. The audit identified shortfalls in the logistic and support services and recommended remedial strategies. The review was conducted by a committee consisting of practising anaesthetists, surgeons and obstetricians who analysed the questionnaires collectively. A consensus was reached to categorise the death. There were 280 pregnancy-related deaths. Post-partum haemorrhage accounted for 31.8%, followed by hypertensive disorders of pregnancy (20.0% obstetric embolism (16.1%), sepsis (10.7%) and associated medical conditions (21.4%). In brief, there were comings in preoperative, intra-operative and post-operative care in some of the cases. Increased consultant input, clinical audit, improvements in monitoring and expansion of critical care facilities were the integral issues recommended.

Matched MeSH terms: Middle Aged

Fulltext Low dose unilateral spinal anaesthesia for lower limb amputation in critically ill patients

Chuah KH, Thong CL, Krshnan H, Chan L

Med J Malaysia, 2007 Mar;62(1):81-2.

PMID: 17682582 MyJurnal

Patients with poorly controlled diabetes mellitus have an increased risk of lower limb infection and gangrene. In Malaysia, they frequently present late and are often in septic shock with multi-organ dysfunction. We report on two patients who presented for lower limb amputation in a desperate attempt to control sepsis and save their lives. Both patients were classified as ASA 5. Both patients had successfully undergone surgery under low dose unilateral spinal anaesthesia. The anaesthetic management of these critically ill patients in view of limited resources is discussed.

Matched MeSH terms: Middle Aged

Epithelial migration in open mastoidectomy cavities

Ong CA, Prepageran N, Godbole S, Raman R

Asian J Surg, 2007 Jan;30(1):57-9.

PMID: 17337373

To study the rate and pattern of epithelial migration in 18 dry, open mastoidectomy cavities.

Matched MeSH terms: Middle Aged

Lifestyle of the elderly in rural and urban Malaysia

Selvaratnam DP, Poo BT

Ann N Y Acad Sci, 2007 Oct;1114:317-25.

PMID: 17986592 DOI: 10.1196/annals.1396.025

Malaysia is steadily progressing toward an aging population demographic pattern. While aging is a natural process, its impact can be painful individually as well as for the nation. Individually there is a loss of a paying job after retirement, loss of physical and mental fitness, and also occasionally the loss of social integration due to lack of mobility. For a nation, an aging population means a growing dependency ratio, a greater need of care, and more medical facilities for this age group. This article looks at the various economic and social implications of the aging population in Malaysia in general, and in the rural and urban setting specifically. The paper focuses on a research sample of 132 (66 rural, 66 urban) elderly persons. The findings suggest that the demographic patterns of the elderly vary from the rural to the urban setting, with differing issues that need to be addressed to alleviate problems encountered related to loneliness, lack of financial stability, and emotional strain. Policy suggestion will be geared toward providing a solution to problems at hand as well as aiding the working group members to prepare and sustain a comfortable livelihood for the aged in their later years.

Matched MeSH terms: Middle Aged

The awareness of oral cancer in adult patients attending School of Dental Sciences, Universiti Sains Malaysia: a preliminary study

Saini R, Ghani ZI, Rahman NA

Singapore Dent J, 2006 Dec;28(1):34-9.

PMID: 17378340

Lack of awareness of signs and symptoms and risk factors of oral cancer can lead to late presentation of the disease that contributes to poor survival of patients who contract it. This study aims to determine the level of awareness regarding oral cancer in adult patients attending School of Dental Sciences, Universiti Sains Malaysia.

Matched MeSH terms: Middle Aged

Demographic and clinical characteristics of chronic prostatitis: prospective comparison of the University of Sciences Malaysia Cohort with the United States National Institutes of Health Cohort

Lee SW, Cheah PY, Liong ML, Yuen KH, Schaeffer AJ, Propert K, et al.

J Urol, 2007 Jan;177(1):153-7; discussion 158.

PMID: 17162027

PURPOSE: We compared demographic and clinical characteristics of the University of Sciences Malaysia Chronic Prostatitis Cohort to the United States National Institutes of Health Chronic Prostatitis Cohort.
MATERIALS AND METHODS: Participants met the same definition of chronic prostatitis/chronic pelvic pain syndrome. Each participant had extensive demographic, medical history, previous treatment, clinical and laboratory evaluations.
RESULTS: The University of Sciences Malaysia and National Institutes of Health cohorts proved similar in most respects. National Institutes of Health-Chronic Prostatitis Symptom Index total scores, pain and urinary subscores were similar for the 332 University of Sciences Malaysia Chronic Prostatitis Cohort and 488 National Institutes of Health Chronic Prostatitis Cohort participants. Differences included worse quality of life subscore for the University of Sciences Malaysia Chronic Prostatitis Cohort, differences in the location, number of sites, and types of pain/discomfort between the 2 populations, and that the University of Sciences Malaysia participants had received less previous treatment.
CONCLUSIONS: The demographic characteristics and clinical presentation of chronic prostatitis/chronic pelvic pain syndrome proved remarkably similar in these diverse populations. Both cohorts experienced major reduction in their quality of life from chronic pelvic pain and urinary symptoms. Comparison of diverse populations using standard clinical, laboratory and assessment instruments is feasible, and may provide important insights into chronic prostatitis/chronic pelvic pain syndrome and the factors that determine clinical outcome.

Matched MeSH terms: Middle Aged

Fulltext Plasmodium knowlesi: the fifth human malaria parasite

White NJ

Clin Infect Dis, 2008 Jan 15;46(2):172-3.

PMID: 18171246 DOI: 10.1086/524889

Matched MeSH terms: Middle Aged

Fulltext Concurrence of duodenal carcinoid and diffuse gastric adenocarcinoma: a rare phenomenon

Srilatha PS

Saudi J Gastroenterol, 2007 Oct-Dec;13(4):197-9.

PMID: 19858647 DOI: 10.4103/1319-3767.36754

Synchronous tumors are well documented in the gastrointestinal tract. Various combinations have been studied. There are a few studies, which highlight the incidental finding of the yellow beauty-the "carcinoid" of the duodenum simultaneously occurring with the venomous "diffuse gastric adenocarcinoma". This is a report one such case in a 58 year-old man, who unfortunately died on the 4th postoperative day due to cardiopulmonary arrest.

Matched MeSH terms: Middle Aged

Heterotopic ossification in skeletal muscle metastasis from colonic adenocarcinoma--a case report

Naik VR, Jaafar H, Mutum SS

Malays J Pathol, 2005 Dec;27(2):119-21.

PMID: 17191396

Colonic adenocarcinoma metastasising to the skeletal muscle is rare. A-56-yr-old Malay man was diagnosed to have adenocarcinoma of the right colon [Dukes B] for which a right hemicolectomy was performed, followed by radiotherapy and chemotherapy. Five years later the patient presented with a mass in the rectus abdominis muscle. The serum carcinoembryonic antigen was 71 ng/Ml. The mass was resected. Gross and microscopical examination showed multiple deposits of mucin-secreting adenocarcinoma with prominent heterotopic ossification in the stroma. The exact pathogenesis and significance of heterotopic ossification is not clear, but bone morphogenetic proteins may play an important role.

Matched MeSH terms: Middle Aged

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: Middle Aged

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: Middle Aged

Fulltext Measurement of patellar thickness in relation to patellar resurfacing

Sulaiman AS, Nordin S

Med J Malaysia, 2005 Jul;60 Suppl C:41-4.

PMID: 16381282

Patellar thickness is an important consideration for resurfacing in total knee arthroplasty. A patella of 25 mm in thickness is not suitable for resurfacing using the currently available total knee systems. A cross sectional study on patellar thickness using plain radiographs was undertaken on 56 patients. It was observed that the average thickness of the bony part of the patella was 20.05 mm (range 17-23 mm). The actual thickness of cartilage varies from 2.0 to 5.5 mm (mean 3.2 mm). Thus the mean thickness of the patella was 23.2 mm (range 20.2-26.2 mm). The majority of our patients (73%) had patellar thickness of 24 mm or less. The patellar thickness had a significant correlation with the patient's height (R=0.5). Since the majority of our patients have thin patella, we are of the opinion that majority of our patients are not suitable for patellar resurfacing.

Matched MeSH terms: Middle Aged

Myelodysplastic syndrome transformed into Acute Lymphoblastic Leukaemia (FAB:L3)

Zainina S, Cheong SK

Clin Lab Haematol, 2006 Aug;28(4):282-3.

PMID: 16898972

Myelodysplastic syndrome (MDS) is recognized as a preleukaemic disorder with a variable risk of transformation to acute myeloid leukaemia. Usually the blast cells in leukaemia are transformed after MDS displays a myeloid phenotype. Even though lymphoid progression had been reported previously, most displayed myeloid-lymphoid hybrid or early B phenotype. We report a case of an elderly man who had MDS transformed into Acute Lymphoblastic Leukaemia (ALL:L3) which is a rare lymphoid transformation.

Matched MeSH terms: Middle Aged

Hand grip strength in the adult Malaysian population

Kamarul T, Ahmad TS, Loh WY

J Orthop Surg (Hong Kong), 2006 Aug;14(2):172-7.

PMID: 16914783

To measure the hand grip strength of Malaysians aged 18 to 65 years.

Matched MeSH terms: Middle Aged

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: Middle Aged

Fulltext Histoplasmosis of the larynx

Subramaniam S, Abdullah AHR, Hairuzah I

Med J Malaysia, 2005 Aug;60(3):386-8.

PMID: 16379201

Primary histoplasmosis of the larynx is not a common disease. Most cases of laryngeal histoplasmosis results from hematogenous spread of disseminated histoplasmosis usually originating from pulmonary infection by Histoplasma capsulatum. We report a 52-year-old male chronic smoker who had prolonged hoarseness and was initially diagnosed with laryngeal carcinoma. However, biopsy of the laryngeal mucosa confirmed the diagnosis of histoplasmosis. There were no signs of pulmonary or systemic involvement. Treatment with intravenous amphotericin B was given for a week and oral ketaconazole was given for a month with complete resolution of symptoms.

Matched MeSH terms: Middle Aged

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