MyMedR

Fulltext Insufficiency fractures related to low-dose adefovir dipivoxil treatment for chronic hepatitis B

Poh F, Sing WH, Mohan PC

Med J Malaysia, 2015 Feb;70(1):38-41.

We present a case of a 53-year-old woman who developed multifocal insufficiency fractures associated with adefovir dipivoxil (ADV) induced osteomalacia, including recurring metatarsal insufficiency fractures and a subtrochanteric femoral insufficiency fracture requiring surgical fixation. She had received low-dose ADV treatment for 59 months for chronic hepatitis B viral infection at the time of presentation with subtrochanteric fracture. Imaging evidence of multifocal insufficiency fractures and metabolic disease on background of hypophosphatemia is attributed to hypophosphatemic osteomalacia from adefovir-induced renal proximal tubular dysfunction. Radiologists and clinicians should be aware of the possibility of insufficiency fractures in patients receiving ADV therapy to avoid delayed diagnosis and progression of high-risk proximal femoral fractures.

Matched MeSH terms: Middle Aged

Evaluation of postural steadiness in below-knee amputees when wearing different prosthetic feet during various sensory conditions using the Biodex® Stability System

Arifin N, Abu Osman NA, Ali S, Gholizadeh H, Wan Abas WA

Proc Inst Mech Eng H, 2015 Jul;229(7):491-8.

PMID: 26019139 DOI: 10.1177/0954411915587595

In recent years, computerized posturography has become an essential tool in quantitative assessment of postural steadiness in the clinical settings. The purpose of this study was to explore the ability of the Biodex(®) Stability System (BSS) to quantify postural steadiness in below-knee amputees. A convenience sample of 10 below-knee amputees participated in the study. The overall (OSI), anterior-posterior (APSI) and medial-lateral (MLSI) stability indexes as well as the percentage of time spent in left and right quadrants and four concentric zones were measured under altered sensory conditions while standing with solid ankle cushion heel (SACH), single-axis (SA) and energy storage and release (ESAR) feet. Significant difference was found between sensory conditions in SACH and ESAR feet for OSI (SACH, p = 0.002; ESAR, p = 0.005), APSI (SACH, p = 0.036; ESAR, p = 0.003) and MLSI (SACH, p = 0.008; ESAR, p = 0.05) stability indexes. The percentage of time spent in Zone A (0°-5°) was significantly greater than the other three concentric zones (p < 0.01). The loading time percentage on their intact limb (80%-94%) was significantly longer than the amputated limb (20%-6%) in all conditions for all three prosthetic feet. Below-knee amputees showed compromised postural steadiness when visual, proprioceptive or vestibular sensory input was altered. The findings highlight that the characteristics of postural stability in amputees can be clinically assessed by utilizing the outcomes produced by the BSS.

Matched MeSH terms: Middle Aged

Fulltext Perceived Barriers and Facilitators for Return to Work Among Colorectal Cancer Survivors: Malaysian Healthcare Professionals Experience-　A Qualitative Inquiry

Chow SL, Loh SY, Su TT

J. UOEH, 2015 Jun 1;37(2):127-38.

PMID: 26073502 DOI: 10.7888/juoeh.37.127

Return to work (RTW) can be a challenging occupational health (OH) issue among previously-employed colorectal cancer survivors. This study aimed to explore the various perceived barriers and facilitators encountered during the RTW process in cancer survivorship, from the perception of healthcare professionals (HCP). Face to face, semistructured interviews were carried out on twelve HCP (government and private sectors) from various disciplines. Data collected were transcribed verbatim and data management was aided by NVivo software 8.0. A new theory from contextual data was generated using open coding, axial coding and selective coding. The HCP shared numerous barriers and facilitators associated with RTW, under four categories. The key barriers were disturbing side effects, psychological barriers (personal factor), compensation (financial factor), poor ability to multitask (work-related factor), long paid medical leaves policy, employer's lackadaisical attitude, lack of knowledge and awareness of RTW (environmental factor). Key facilitators identified were desire to resume working life and to contribute to society (personal factor), financial pressure, maintain organizational health insurance (financial factor), less physically demanding job (work-related factor), supportive workplace and strict organizational policy on medical leaves (environmental factor). While not all HCP were trained in RTW, they all agreed that RTW is important for survivors and workplace. Occupational health doctors have a direct role in helping survivors RTW. Early Intervention on RTW during survivorship should involve occupational health doctors and employers, targeting the modifiable factors (environmental and work-related) to improve RTW after cancer.

Matched MeSH terms: Middle Aged

Fulltext Utility of pre-treatment neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as prognostic factors in breast cancer

Koh CH, Bhoo-Pathy N, Ng KL, Jabir RS, Tan GH, See MH, et al.

Br. J. Cancer, 2015 Jun 30;113(1):150-8.

PMID: 26022929 DOI: 10.1038/bjc.2015.183

Peripheral blood-derived inflammation-based scores such as the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have recently been proposed as prognostic markers in solid tumours. Although evidence to support these markers as unfavourable prognostic factors is more compelling in gastrointestinal cancers, very little is known of their impact on breast cancer. We investigated the association between the NLR and PLR, and overall survival after breast cancer.

Matched MeSH terms: Middle Aged

ConnectViz: Accelerated Approach for Brain Structural Connectivity Using Delaunay Triangulation

Adeshina AM, Hashim R

Interdiscip Sci, 2016 Mar;8(1):53-64.

PMID: 26260066 DOI: 10.1007/s12539-015-0274-9

Stroke is a cardiovascular disease with high mortality and long-term disability in the world. Normal functioning of the brain is dependent on the adequate supply of oxygen and nutrients to the brain complex network through the blood vessels. Stroke, occasionally a hemorrhagic stroke, ischemia or other blood vessel dysfunctions can affect patients during a cerebrovascular incident. Structurally, the left and the right carotid arteries, and the right and the left vertebral arteries are responsible for supplying blood to the brain, scalp and the face. However, a number of impairment in the function of the frontal lobes may occur as a result of any decrease in the flow of the blood through one of the internal carotid arteries. Such impairment commonly results in numbness, weakness or paralysis. Recently, the concepts of brain's wiring representation, the connectome, was introduced. However, construction and visualization of such brain network requires tremendous computation. Consequently, previously proposed approaches have been identified with common problems of high memory consumption and slow execution. Furthermore, interactivity in the previously proposed frameworks for brain network is also an outstanding issue. This study proposes an accelerated approach for brain connectomic visualization based on graph theory paradigm using compute unified device architecture, extending the previously proposed SurLens Visualization and computer aided hepatocellular carcinoma frameworks. The accelerated brain structural connectivity framework was evaluated with stripped brain datasets from the Department of Surgery, University of North Carolina, Chapel Hill, USA. Significantly, our proposed framework is able to generate and extract points and edges of datasets, displays nodes and edges in the datasets in form of a network and clearly maps data volume to the corresponding brain surface. Moreover, with the framework, surfaces of the dataset were simultaneously displayed with the nodes and the edges. The framework is very efficient in providing greater interactivity as a way of representing the nodes and the edges intuitively, all achieved at a considerably interactive speed for instantaneous mapping of the datasets' features. Uniquely, the connectomic algorithm performed remarkably fast with normal hardware requirement specifications.

Matched MeSH terms: Middle Aged

Basaloid Squamous Cell Carcinoma: An Unusual Ball-Valve Laryngeal Obstruction

Tan SH, Hindi KW, Chandran PA, Chong AW

Iran J Otorhinolaryngol, 2015 May;27(80):243-6.

PMID: 26082908

INTRODUCTION: A rare case of basaloid squamous cell carcinoma (BSCC) of the larynx, which has not been previously reported, is described.

CASE REPORT: A 60-year-old man was presented to the Otolaryngology Department with progressive dyspnoea and dysphagia to solids for over a period of 1 week. Direct laryngoscopy revealed a tumour at the laryngeal aspect of the epiglottis, which prolapsed into the laryngeal inlet each time the patient inspired. This resulted in an inspiratory stridor despite adequate glottic opening and normal mobility of the vocal cords.

CONCLUSION: Therefore, in cases where a ball-valve lesion causes intermittent life-threatening airway obstruction, BSCC of the larynx, though rare, must be considered as a differential diagnosis.

Matched MeSH terms: Middle Aged

Survival rates of cervical cancer patients in Malaysia

Muhamad NA, Kamaluddin MA, Adon MY, Noh MA, Bakhtiar MF, Ibrahim Tamim NS, et al.

Asian Pac J Cancer Prev, 2015;16(7):3067-72.

PMID: 25854407

Cervical cancer is the most common malignant cancer of the female reproductive organs worldwide. Currently, cervical cancer can be prevented by vaccination and detected at an early stage via various screening methods. Malaysia, as a developing country faces a heavy disease burden of cervical cancer as it is the second most common cancer among Malaysian women. This population based study was carried out to fulfil the primary aim of determining the survival rates of Malaysian women with cervical cancer and associated factors. Data were obtained from two different sources namely, the Malaysian National Cancer Registry (MNCR) and National Health Informatics Centre (NHIC) from 1st January 2000 to 31st December 2005. Kaplan Meier analyses were conducted to identify the overall survival rates and median survival time. Differences in survival among different ethnic and age group were compared using the log-rank test. A total of 5,859 patients were included. The median survival time for cervical cancer in this study was 65.8 months and the 5-year survival rate was 71.1%. The overall observed survival rates at 1, 3 and 5 years were 94.1%, 79.3% and 71.1% respectively. The log-rank test finding also showed that there were significant differences in the 5-year survival rate among different ethnic groups. Malays had the lowest survival rate of 59.2% followed by Indians (69.5%) and Chinese (73.8%). The overall 5-year survival rate among patients with cervical cancer in Malaysia is relatively good. Age and ethnic groups remain as significant determining factors for cervical cancer survival rate.

Matched MeSH terms: Middle Aged

Aggressive renal tumour: squamous cell carcinoma with sarcomatoid differentiation

Shepherd ARH, Hoh IMY, Goh EH, Cohen PA, Steele D

ANZ J Surg, 2017 Dec;87(12):1054-1056.

PMID: 25962888 DOI: 10.1111/ans.13155

Matched MeSH terms: Middle Aged

Fulltext Laparoscopic sleeve gastrectomy in Asia: Long term outcome and revisional surgery

Pok EH, Lee WJ, Ser KH, Chen JC, Chen SC, Tsou JJ, et al.

Asian J Surg, 2016 Jan;39(1):21-8.

PMID: 25964106 DOI: 10.1016/j.asjsur.2015.03.006

Laparoscopic sleeve gastrectomy (LSG) is a popular stand-alone bariatric surgery, despite a paucity of long-term data. Hence, this study is to report the long-term outcome of LSG as primary bariatric procedure and the result of revisional surgery.

Matched MeSH terms: Middle Aged

Islamic Personal Religiosity as a Moderator of Job Strain and Employee's Well-Being: The Case of Malaysian Academic and Administrative Staff

Achour M, Mohd Nor MR, MohdYusoff MY

J Relig Health, 2016 Aug;55(4):1300-11.

PMID: 25835985 DOI: 10.1007/s10943-015-0050-5

Presently, there is increased in research on job strain and the effects of religiosity on employee well-being. Despite increased recognition of religiosity as a moderator of well-being, limited research has focused on Islamic perspective of moderating job strain. This study examines the moderating effects of Islamic personal religiosity on the relationship between job strain and employee well-being in Malaysian universities. One hundred and seventeen (117) Muslim academic and administrative staff from four public universities were sampled. Data were collected via questionnaires, and our findings show that the effect of job strain on well-being is significant for employees and that personal religiosity of employees contributed to alleviating job strain and enhancing well-being. Thus, the study concludes that Islamic personal religiosity moderates the relationship between job strain and employee well-being.

Matched MeSH terms: Middle Aged

Fulltext Transcervical diverticulectomy for Killian-Jamieson diverticulum

Siow SL, Mahendran HA, Hardin M

Asian J Surg, 2017 Jul;40(4):324-328.

PMID: 25779884 DOI: 10.1016/j.asjsur.2015.01.007

Surgery for Killian-Jamieson diverticulum of the esophagus is scarcely reported in the literature owing to the rarity of this entity. This is a case report of such a diverticulum and a description of the transcervical diverticulectomy that we performed on a 49-year-old lady. The patient was investigated for symptoms of gastroesophageal reflux disease and was diagnosed with a left-sided Killian-Jamieson diverticulum.

Matched MeSH terms: Middle Aged

Complications of otitis media requiring surgical intervention

Long YT, Mahmud R, Sani A, Saim L

Asian J Surg, 2002 Apr;25(2):170-4.

PMID: 12376240

Although the incidence of complications of otitis media that require surgical interventions has decreased substantially over the past few years, it is a prevailing condition for which clinicians should remain vigilant.

Matched MeSH terms: Middle Aged

Fulltext Reconstruction of lower leg defects using a medial island fasciocutaneous flap

Naresh B, Parameswaran S

Med J Malaysia, 1998 Sep;53 Suppl A:77-82.

PMID: 10968186

It is usually a major task providing soft tissue cover to significant defects of the lower leg. A wide variety of flaps and techniques are available, each with its advantages and limitations. Previously described anatomic study of the septocutaneous vessels of the leg have indicated a consistent lower most perforator at 9-12 cm from the tip of the medial malleolus. An island fasciocutaneous flap based on this perforator vessels can be raised subfascially. After the vessels have been dissected clean down to the posterior tibial artery, it can be rotated up to 180 degrees degrees. Successful soft tissue reconstruction was achieved in 18 patients. Most of the tissue loss was due to trauma and were around the ankle and the heel. There were 7 minor complications which resolved completely after 2 months. Its simplicity of design and elevation plus its extensive arc of rotation makes it a reliable and versatile flap in the reconstruction of lower leg defects.

Matched MeSH terms: Middle Aged

Fulltext The results of surgical treatment of tibial plateau fractures

Ruslan GS, Razak M

Med J Malaysia, 1998 Sep;53 Suppl A:35-41.

PMID: 10968181

Thirty-eight tibial plateau fractures were treated with open reduction and internal fixation. The fractures were classified into six groups (Hohl's 1991 Classification) and the clinical results were evaluated using the Rasmussen (1973) criteria. The average follow-up period was 2.07 years. Overall there was one excellent, thirty-four (34) good, three fair and no poor results. In three patients with less than a good score there were other associated ipsilateral injuries and delayed mobilisation of the knee joint. There was no direct association between the type of internal fixation and the end result.

Matched MeSH terms: Middle Aged

Primary squamous cell carcinoma of the thyroid--a case report

Wan Muhaizan WM, Phang KS, Sharifah NA, al Amin D

Malays J Pathol, 1998 Dec;20(2):109-11.

PMID: 10879272

A rare case of primary squamous cell carcinoma of the thyroid is reported herein. A 64-year-old Malay lady presented with a gradually enlarging thyroid nodule for the past 6 months and underwent total thyroidectomy. Histopathology revealed a squamous cell carcinoma of the thyroid with complete resection. Possible primary tumour elsewhere was excluded. Postoperative irradiation was given and patient is still alive after 2 years of follow-up.

Matched MeSH terms: Middle Aged

Fulltext Non-sporulating Chrysosporium: an opportunistic fungal infection in a neutropenic patient

Gan GG, Kamarulzaman A, Goh KY, Ng KP, Na SL, Soo-Hoo TS

Med J Malaysia, 2002 Mar;57(1):118-22.

PMID: 14569730

We report a case of an invasive infection with non-sporulating Chrysosporium species in a patient who was treated with chemotherapy for relapsed acute lymphoblastic leukemia. This patient presented with a persistent lobar pneumonia, skin lesions, and possible involvement of the central nervous system. The patient responded to treatment with amphotericin B and oral itraconazole.

Matched MeSH terms: Middle Aged

Total thyroidectomy: the procedure of choice for multinodular goitre

Hisham AN, Azlina AF, Aina EN, Sarojah A

Eur J Surg, 2001 Jun;167(6):403-5.

PMID: 11471662 DOI: 10.1080/110241501750243725

OBJECTIVE: To review our experience of total thyroidectomy for bilateral multinodular goitre.
DESIGN: Prospective open study.
SETTING: Teaching hospital, Malaysia.
SUBJECTS: 98 consecutive patients whose bilateral multinodular goitres were treated by total thyroidectomy, January 1998-November 1999.
INTERVENTION: A revised technique of total thyroidectomy in which more attention than is customary was paid to the exposure and safety of the laryngeal nerves and the parathyroid glands. All patients had at least 1 parathyroid gland autotransplanted.
MAIN OUTCOME MEASURES: Morbidity and mortality
RESULTS: There were no injuries to the recurrent laryngeal nerves and no patient developed persistent hypocalcaemia; 27/98 developed transient hypocalcaemia, but this had settled by 6 months postoperatively. 59 patients had persistent symptoms of pressure preoperatively, and these all resolved by 3 months postoperatively. 6 patients had occult malignant disease discovered on histological examination, and 3 developed minor wound infections.
CONCLUSIONS: Total thyroidectomy is the procedure of choice for bilateral multinodular goitres, provided that sufficient attention is paid to the preservation of the laryngeal nerves and the parathyroid glands.

Matched MeSH terms: Middle Aged

Fulltext A report of two non-AIDS associated Kaposi's sarcoma in Malaysia

Choon SE, Khoo JJ

Med J Malaysia, 1997 Dec;52(4):437-40.

PMID: 10968124

Kaposi's sarcoma is an uncommon cutaneous neoplasm seen classically in elderly males of East European or Jewish extract. It has been known to be endemic in sub-Saharan Africa for many years. Numerous cases had been described in patients on long-term immunosuppressive therapy and in patients living with acquired immunodeficiency syndrome (AIDS). In spite of the increasing number of organ transplant recipients and people living with AIDS. Kaposi's sarcoma remains rare in Asia. We report two cases seen in Johor, Malaysia.

Matched MeSH terms: Middle Aged

Fulltext Nifedipine-induced hypotensive shock

Ramanathan M, Ahmad F

Med J Malaysia, 1997 Dec;52(4):444.

PMID: 10968126

Matched MeSH terms: Middle Aged

Fulltext Bleomycin and oxytetracycline sclerotherapy for malignant pleural effusions

Liam CK, Lim KH, Wong CMM

Med J Malaysia, 2000 Jun;55(2):283-4.

PMID: 19839164

Matched MeSH terms: Middle Aged