MyMedR

Fulltext Challenges in diagnosis and management of pseudoptosis secondary to asymmetrical skin creases

Ting SL, Koay AC, Yew YH, Chua CN

Med J Malaysia, 2011 Jun;66(2):121-3.

Asymmetrical eyelid skin crease may be mistaken for ptosis due to apparent narrowing of the palpebral fissure in the eye without the skin crease. This study describes a series of patients who were mistakenly referred for ptosis operation as a result of absent skin crease.

Matched MeSH terms: Adolescent

Fulltext Risk-adjusted analysis of patients undergoing laparotomy using POSSUM and P-POSSUM score in Queen Elizabeth Hospital, Sabah

Chieng TH, Roslan AC, Chuah JA

Med J Malaysia, 2010 Dec;65(4):286-90.

PMID: 21901947

Scoring systems such as POSSUM and P-POSSUM have been developed to help predict mortality and morbidity in patients. The ratio of observed-to-predicted (O/P ratio) mortality and morbidity has been used as a performance indicator to compare different procedures, clinicians or hospitals. The aim of this study was to assess the predictive value of POSSUM compared with P-POSSUM in patients undergoing laparotomy in Queen Elizabeth Hospital, Sabah.

Matched MeSH terms: Adolescent

Fulltext Dural tear post mastoidectomy repaired with Dura Gen

Wong CY, Khairi MD, Mohamed SA, Irfan M

Med J Malaysia, 2010 Dec;65(4):307-8.

PMID: 21901952

Dural exposure may occur during the course of thinning the tegmen tympani and tegmen mastoideum in mastoid procedure. If large area of dura is exposed or lacerated, cerebrospinal fluid and brain herniation may enter the mastoid cavity. We report a case of a patient with injured dura mater and tegmen mastoideum during mastoidectomy for chronic suppurative otitis media with cholesteatoma managed by using DuraGen. The dura mater and tegmen defect healed totally showing the success of the procedure. A collagen matrix like DuraGen is an option for repairing dural tear in mastoid region.

Matched MeSH terms: Adolescent

Fulltext Management of isolated splenic injuries after blunt trauma: an institution's experience over 6 years

Tan KK, Chiu MT, Vijayan A

Med J Malaysia, 2010 Dec;65(4):304-6.

PMID: 21901951

Forty-two patients with traumatic blunt splenic injuries were admitted over a six year period. Vehicular-related collisions and fall from height accounted for the injuries in 38 (90.5%) of them. Eleven (26.2%) underwent immediate surgery (7 splenectomy and 4 splenorrhaphy), while the remaining 31 patients were treated nonoperatively of which 3 underwent angio-embolisation. Twenty seven patients had either grade III or IV splenic injuries. Operative management was more likely in patients with lower haemoglobin or with more severe splenic injury. Nonoperative management can be adopted in patients with blunt isolated splenic injuries but operative management is still indispensable in certain instances.

Matched MeSH terms: Adolescent

Fulltext School scoliosis screening programme-a systematic review

Sabirin J, Bakri R, Buang SN, Abdullah AT, Shapie A

Med J Malaysia, 2010 Dec;65(4):261-7.

PMID: 21901941

A systematic review on the effectiveness and cost-effectiveness of school scoliosis screening programme was carried out. A total of 248 relevant titles were identified, 117 abstracts were screened and 28 articles were included in the results. There was fair level of evidence to suggest that school scoliosis screening programme is safe, contributed to early detection and reduction of surgery. There was also evidence to suggest that school-based scoliosis screening programme is cost-effective. Based on the above review, screening for scoliosis among school children is recommended only for high risk group such as girls at twelve years of age.
Keywords: Systematic review, scoliosis screening

Matched MeSH terms: Adolescent

Bitten by the "flying" tree snake, Chrysopelea paradisi

Tan TL, Ismail AK, Kong KW, Ahmad NK

J Emerg Med, 2012 Apr;42(4):420-3.

PMID: 22154775 DOI: 10.1016/j.jemermed.2011.03.038

The paradise tree snake, Chrysopelea paradisi, is a rear-fanged colubrid. Like other members of the genus Chrysopelea, it is able to glide through the air, and thus, is commonly known as a "flying snake." There are few documented effects of its bite on humans.

Matched MeSH terms: Adolescent

Malignant hypertension with papilledema

Tajunisah I, Patel DK

J Emerg Med, 2013 Jan;44(1):164-5.

PMID: 21820265 DOI: 10.1016/j.jemermed.2011.05.042

Matched MeSH terms: Adolescent

Fulltext Predicted equations for ventilatory function among Kuching (Sarawak, Malaysia) population

Djojodibroto RD, Pratibha G, Kamaluddin B, Manjit SS, Sumitabha G, Kumar AD, et al.

Med J Malaysia, 2009 Dec;64(4):275-9.

PMID: 20954550 MyJurnal

Spirometry data of 869 individuals (males and females) between the ages of 10 to 60 years were analyzed. The analysis yielded the following conclusions: 1. The pattern of Forced Vital Capacity (FVC) and Forced Expiratory Volume in One Second (FEV1) for the selected subgroups seems to be gender dependant: in males, the highest values were seen in the Chinese, followed by the Malay, and then the Dayak; in females, the highest values were seen in the Chinese, followed by the Dayak, and then the Malay. 2. Smoking that did not produce respiratory symptom was not associated with a decline in lung function, in fact we noted higher values in smokers as compared to nonsmokers. 3. Prediction formulae (54 in total) are worked out for FVC & FEV1 for the respective gender and each of the selected subgroups.

Matched MeSH terms: Adolescent

Fulltext Profile of low vision children in the special education schools in Malaysia

Omar R, Mohammed Z, Knight VF, Basrul MH

Med J Malaysia, 2009 Dec;64(4):289-93.

PMID: 20954552

This study looked at the causes of vision loss, levels of distance, near vision and the use of low vision devices (LVDs) in children studying at special schools in Malaysia. A total of 139 children from two special education schools took part. Visual acuity was measured with and without LVDs. Those who required further assessment were referred to Low Vision Clinic. Near visual acuity in 71 children ranged from N4 to N64. Sixty eight children could not read the N64 chart or they were totally blind. Only eight students were using LVDs before intervention. Seventy one children were referred for low vision assessment and 48 were found to benefit from the LVDs prescribed. The major cause of visual impairment was cataract (17%). Hand held magnifier was the most preferred LVD. Majority of the children attending the blind schools had residual vision but did not have LVDs. LVDs are able to significantly improve near visual acuity and hence there is a need to prescribe and train the children to use the LVDs.

Matched MeSH terms: Adolescent

Fulltext Human Plasmodium knowlesi infections in Klang Valley, Peninsula Malaysia: a case series

Lee CE, Adeeba K, Freigang G

Med J Malaysia, 2010 Mar;65(1):63-5.

PMID: 21265252

We report seven cases of naturally acquired human Plasmodium knowlesi infections which were admitted to our centre from July 2007 till June 2008. Diagnosis was confirmed by nested PCR. Cases of P. knowlesi infections, dubbed the fifth type of human malaria, have been reported in East Malaysia (Sabah and Sarawak) as well as in the state of Pahang in Peninsula Malaysia. These seven patients appear to be the first few reported cases of P. knowlesi infection in the Klang valley, Peninsula Malaysia. We then discuss the characteristics of human P. knowlesi infections, which include its natural hosts, responsible vectors, clinical presentation, and the treatment of such infections.

Matched MeSH terms: Adolescent

Fulltext Granulomatous prostatitis: a reminder to clinicians

Shanggar K, Zulkifli MZ, Razack AH, Dublin N

Med J Malaysia, 2010 Mar;65(1):21-2.

PMID: 21265242 MyJurnal

Granulomatous Prostatitis (GnP) is a heterogenous entity classified into specific infections, non-specific infections, post surgical i.e. post-transurethral resection of prostate (TURP) and rare secondary (systemic) causes. A total of 1388 reports of prostatic biopsy and prostatic chips from TURP were reviewed from 1995 and 2007. The results which showed granulomatous prostatitis were analyzed and retrospective data collected from the patient's records. A total of 9 cases with granulomatous prostatitis were identified. There are 3 types of entities which are the non-specific (NSGnP), post-TURP and the specific type. The incidence of GnP in our center is lower than reported by Stillwell et al. The majority of the patients were Malays.

Matched MeSH terms: Adolescent

A cross-sectional validation study of EQ-5D among the Malaysian adult population

Shafie AA, Hassali MA, Liau SY

Qual Life Res, 2011 May;20(4):593-600.

PMID: 21046257 DOI: 10.1007/s11136-010-9774-6

PURPOSE: The objective of this study was to assess the construct validity of the EQ-5D instrument among the Malaysian population.

METHODS: This was a cross-sectional study conducted among Malaysian adults in three northern states of Malaysia. A pre-developed questionnaire consisting of both the EQ-5D and SF-12 items was used for data collection. Concurrent, convergent, and known group validity of EQ-5D were assessed against SF-12 and several known relationships with participants' demographic and illness characteristics.

RESULTS: A total of 596 Malaysians participated in the study. The mean EQ-5D score was 0.93 (SD = 0.13), while the mean physical component score (PCS-12) and mental component score (MCS-12) scores were 48.9 (SD = 7.4) and 49.1 (SD = 8.0), respectively. Participants with a current medical problem had lower PCS-12 and MCS-12 scores and reported more problems with all of the EQ-5D dimensions; they also had lower EQ-5D and EQ-VAS scores (P < 0.05). Convergent validity was supported by a moderately positive correlation between EQ-5D and EQ-VAS with MCS-12 and PCS-12 scores; moreover, the stronger effect sizes between PCS-12 and the physical dimensions of EQ-5D as well as between MCS-12 with anxiety/depression scores further supported the convergent validity of EQ-5D. Responses to the EQ-5D dimensions only supported two of the four known group validity hypotheses of higher quality of life among individuals who are better educated and no medical problem. No association was found between income and gender with EQ-5D score.

CONCLUSION: This study has demonstrated acceptable construct validity of the EQ-5D among the Malaysian population.

Matched MeSH terms: Adolescent

Randomised comparison of the LMA Supreme with the I-Gel in spontaneously breathing anaesthetised adult patients

Chew EE, Hashim NH, Wang CY

Anaesth Intensive Care, 2010 Nov;38(6):1018-22.

PMID: 21226431

We compared the performance of the LMA Supreme (SLMA) with the I-Gel during anaesthesia in spontaneously breathing adult patients. Ninety patients with American Society of Anesthesiologists physical status I or II were studied in a prospective randomised controlled study. Our primary outcome measure was oropharyngeal leak pressure. We also compared the overall insertion success rate, ease of insertion, adequacy of ventilation and incidence of complications. The mean (SD), oropharyngeal leak pressure for the SLMA was 25.6 (5.1) cmH2O, which was greater than for the I-Gel 20.7 (5.9) cmH2O (P = 0.0001). The first attempt and overall insertion success rates were similar between the two groups (SLMA 97.8 and 97.8%; I-Gel 93.3 and 100%, P = 0.132). The SLMA was rated easier to insert than the I-Gel (P = 0.011), but the time taken for insertion (P = 0.433) was similar. The incidence of complications was low in both groups. The grade of fibreoptic view was better with the I-Gel than the SLMA (P = 0.001). We conclude that in adults with normal airways, the SLMA is easier to insert and provides a higher oropharyngeal leak pressure, but fibreoptic views are better with the i-gel.

Matched MeSH terms: Adolescent

Fulltext Pahang melioidosis registry

How SH, Ng TH, Jamalludin AR, Tee HP, Kuan YC, Alex F, et al.

Med J Malaysia, 2009 Mar;64(1):27-30.

PMID: 19852316 MyJurnal

Melioidosis has a high annual incidence and mortality rate in Pahang, Malaysia. We initiated the first melioidosis registry in the country on 1st July 2005 to improve the management of melioidosis in the state. Continuous medical education on melioidosis was carried out in all hospitals in the state to highlight the magnitude of the disease and to educate the doctors on the treatment of the disease. All culture confirmed cases were registered and analysed. During the one-year study period from 1st July 2005 till 30th June 2006, a total of 63 patients had positive culture for Burkholderia pseudomallei. The calculated annual incidence of melioidosis in Pahang state was 4.3 per 100,000 population per year (Adult, 6.0 per 100, 000 population per year and paediatric, 1.6 per 100,000 population per year). There were 55 Malays (87.3%), three Chinese (4.8%), four aborigines (6.3%) and one Indonesian. Nine (14.3%) were less than 18 years old. The median age was 49 years (range: 1-68 years). Only one patient (1.6%) had a previous history of confirmed melioidosis. With this programme, we had observed a decline in adult mortality from 54% to 44%, although this was not statistically significant. However, culture-confirmed relapses had dropped from 19% to nil. Several measures need to be taken to decrease mortality from melioidosis in endemic countries.

Matched MeSH terms: Adolescent

Fulltext Adult allogeneic haematopoietic stem cell transplantation: a single centre experience in Malaysia

Gan GG, Zakaria Z, Sangkar JV, Haris AR, Bee PC, Chin E, et al.

Med J Malaysia, 2008 Oct;63(4):281-7.

PMID: 19385485 MyJurnal

We analysed the outcome of 104 patients from a single institution who underwent allogeneic haematopoietic stem cell transplantation (AHSCT) from their HLA-identical siblings between 1993 and 2006. Sixty-nine percent of patients had peripheral blood stem cell (PBSC) as the stem cell source and the remaining had bone marrow (BM). The majority of patients are Chinese (60%) followed by Malays (24%) and Indians (14%). The median time to reach white cell counts of >1 x 10(9)/L and platelet counts of >30 x 10(9)/L was 13 and 15 days, respectively in patients who had PBSC transplantation compared with 16 and 25 days in patients who had BM transplantation, (p < 0.0001 and p < 0.001). Acute graft-versus-host disease (aGVHD) of grade II to IV was observed in 34% of patients and chronic graft-versus-host disease (cGVHD) in 38% of patients. Although not statistically significant, there was a higher incidence of overall aGVHD in Indian patients (73%) compared to Chinese and Malays (57% and 56% respectively). There was no significant difference in the incidence of aGVHD and cGVHD with the source of stem cells. Overall survival (OS) and disease free survival (DFS) was 50% and 60% at five years respectively. Multivariate analysis showed that patients transplanted in standard risk and those who had limited cGVHD had a significant better OS, (p = 0.05 and p = 0.05). Patients who had cGVHD and transplanted in standard risk had a better DFS, (p = 0.002 and p < 0.001). In summary, AHSCT in standard risk patients is associated with a better outcome than those transplanted in high risk and although not statistically significant, there is a higher incidence of aGVHD in Indian patients.

Matched MeSH terms: Adolescent

An insight into industrial accidents involving the hand

Abdullah S, Jaafar JM, Das S, Sapuan J

Clin Ter, 2009;160(6):427-33.

PMID: 20198282

BACKGROUND: Industrial hand injuries are a common occurrence and contributes to a large segment of workers' morbidity. The main aim of this study was to look into the day pattern, types and location of upper limbs injures, identify the types of machines involved and highlight the treatment received.
MATERIALS AND METHODS: The present study was performed on 57 industrial workers admitted and treated by the Orthopaedic team of Universiti Kebangsaan Malaysia Medical Centre (UKMMC) for acute injuries sustained whilst working.
RESULTS: The majority of the workers were male (93%). The commonest age group involved was between 25-35 years (48%). The right hand was injured more then the left with majority of injuries involving the fingers. Interestingly, we also observed that injuries occurred more on Saturdays. Laceration was the most common injury followed by fractures and crush injuries. Treatment depends on the type and severity of injuries. For most lacerated wounds, treatment was debridement, primary suturing and antibiotic therapy. Injuries on Saturdays indicated that workers needed a longer time break especially during weekends after a long hectic week.
CONCLUSIONS: Injuries sustained by workers may be prevented by proper working techniques and conditions together with wearing of protective gadgets.

Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)

Matched MeSH terms: Adolescent

Sex differences from fingerprint ridge density in Chinese and Malaysian population

Nayak VC, Rastogi P, Kanchan T, Yoganarasimha K, Kumar GP, Menezes RG

Forensic Sci Int, 2010 Apr 15;197(1-3):67-9.

PMID: 20071110 DOI: 10.1016/j.forsciint.2009.12.055

The fingerprints are very typical for a human being. The present study was undertaken to study the gender differences in fingerprint ridge density in Chinese and Malaysian population. The study done on 200 subjects (100 males and 100 females) of Chinese origin and 100 subjects (50 males and 50 females) of Malaysian origin revealed that significant gender differences occur in the finger ridge density. Fingerprint mean ridge density of 12 ridges/25 mm(2) or less is found to be more likely to be of males and a mean ridge count of more the 13 ridges/25 mm(2) is more likely of female origin in Chinese subjects. Fingerprint mean ridge density of 11 ridges/25 mm(2) or less is found to be more likely to be of males and a mean ridge count of more the 13 ridges/25 mm(2) is more likely of female origin in Malaysian subjects.

Matched MeSH terms: Adolescent

Fulltext Cutaneous lupus erythematosus in Sarawak, East Malaysia

Yap FBB

Indian J Dermatol Venereol Leprol, 2009 May-Jun;75(3):302-3.

PMID: 19439888 DOI: 10.4103/0378-6323.51262

Matched MeSH terms: Adolescent

Fulltext Spectrum of thyroid lesions in hospital Universiti Sains Malaysia over 11years and a review of thyroid cancers in Malaysia

Othman NH, Omar E, Naing NN

Asian Pac J Cancer Prev, 2009;10(1):87-90.

PMID: 19469631

INTRODUCTION: Endemic goitre is a major concern in many nations including Malaysia. Seven states in the country have been identified by Ministry of Health of Malaysia to have high incidence of goitre and one of these is Kelantan.

METHODS: This is a retrospective study over an 11-year period from 1994 to 2004 on all thyroid specimens submitted to the Pathology Department, Hospital Universiti Sains Malaysia (HUSM), in Kelantan. Epidemiological data were retrieved from the patients' records and pathology findings from the pathology reports.

RESULTS: During this period, Department of Pathology HUSM received a total of 1,486 thyroid specimens. The female to male ratio was 6:1 and the median age was 40.0 years. The duration of goitre ranged from one to 15 years. Histopathological examination showed 71.9 percent were non-neoplastic and 28.1 percent neoplastic lesions. The hospital-based incidence of nodular hyperplasia was 9.9 per 100,000 admitted patients per year. The hospital-based incidence of all types of malignant thyroid cancers was 3.5 per 100,000. The most common malignancy was papillary carcinoma 76.6 percent. The majority of the cancers (59.5 percent) occurred in a background of nodular hyperplasia. Thyroid cancers made up 4.9 percent of all cancers seen in HUSM.

CONCLUSION: This study suggests that malignant thyroid lesions arising from multi-nodular goitre are high in a population living in an iodine-deficiency area.

Matched MeSH terms: Adolescent

Fulltext Screening of dystrophin gene deletions in Malaysian patients with Duchenne muscular dystrophy

Marini M, Salmi AA, Watihayati MS, SMardziah MD, Zahri MK, Hoh BP, et al.

Med J Malaysia, 2008 Mar;63(1):31-4.

PMID: 18935728 MyJurnal

Duchenne Muscular Dystrophy (DMD) is an X-linked recessive genetic disorder characterized by rapidly progressive muscle weakness. The disease is caused by deletion, duplication or point mutation of the dystrophin gene, located on the X chromosome (Xp21). Deletion accounts for 60% of the mutations within the 79 exons of the dystrophin gene. Seven exons (43, 44, 45, 46, 49, 50, and 51) were found to be most commonly deleted among the Asian patients. To detect the frequency of deletion of these 7 exons in Malaysian DMD patients, we carried out a molecular genetic analysis in 20 Malaysian DMD patients. The mean age of initial presentation was 60 months (SD 32 months, range 5-120 months). Fourteen patients were found to have deletion of at least one of the seven exons. The remaining six patients did not show any deletion on the tested exons. Deletions of exons 49, 50 and 51 were the most frequent (71.43%) and appear to be the hot spots in our cohort of patients.

Matched MeSH terms: Adolescent

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