MyMedR

Giant cell arteritis presenting as chronic cough and prolonged fever

Lim KH, Liam CK, Vasudevan AE, Wong CM

Respirology, 1999 Sep;4(3):299-301.

PMID: 10489679 DOI: 10.1046/j.1440-1843.1999.00195.x

A 62-year-old man presented with a 3-month history of chronic non-productive cough and unexplained fever. Further questioning revealed that he had headaches and myalgia. Bilateral thickened temporal arteries were noted on physical examination. The erythrocyte sedimentation rate was 96 mm in 1 h. A biopsy specimen of the left temporal artery showed inflammatory changes consistent with the diagnosis of giant cell arteritis. Commencement of prednisolone resulted in rapid and dramatic resolution of his symptoms. Physicians should be aware of respiratory symptoms in patients with giant cell arteritis in order to avoid delay in diagnosis and therapy of this condition.

Matched MeSH terms: Middle Aged

Tuberculous pleurisy as a manifestation of primary and reactivation disease in a region with a high prevalence of tuberculosis

Liam CK, Lim KH, Wong CM

Int J Tuberc Lung Dis, 1999 Sep;3(9):816-22.

PMID: 10488891

A teaching hospital in Malaysia.

Matched MeSH terms: Middle Aged

Fulltext Pregnancy in patients with renal transplants in Malaysia

Hooi LS, Rozina G, Wan Shaariah MY, Teo SM, Tan CHH, Bavanandan S, et al.

Med J Malaysia, 2003 Mar;58(1):27-36.

PMID: 14556324

There were 72 pregnancies in 46 renal transplants (RTs) between 1984 and 2001, 89% from living donors, 11% cadaveric. Mean age at RT was 26.9 +/- 4.3 years and at pregnancy 30.7 +/- 4.7 years. Mean time to pregnancy after RT was 4.5 +/- 3.1 years. 54% were unplanned. 45 (63%) resulted in surviving infants, 37% delivered by Caesarean section. 35% were premature. Mean birth weight was 2.38 +/- 0.57 kg. 64% were on cyclosporine. No patient had an acute rejection during pregnancy; 38% had pre-existing hypertension. Complications include urinary infection (13%), proteinuria (15%) and preeclampsia (15%). Mean serum creatinine before pregnancy was 112.7 +/- 32.6 umol/l, 1 year post-pregnancy it was 119.4 +/- 38.7. The mean time of follow up of mothers is 4.9 +/- 3.5 years. 10 year graft survival was 83% and patient survival 94%.

Matched MeSH terms: Middle Aged

Fulltext Quality of life--how do Malaysian asthmatics fare?

Sararaks S, Rugayah B, Azman AB, Karuthan C, Low LL

Med J Malaysia, 2001 Sep;56(3):350-8.

PMID: 11732082

Asthma can place considerable restrictions on the physical, emotional and social aspects of the lives of patients. The assessment of quality of life aims to provide a means of measuring the impact of this disease on patients' lives, from the patients' perspective. A cross sectional multi-centre study was conducted in six government hospitals throughout the country. Self-administered SF-36 was used, and clinical information obtained through interviews and examination. 1612 asthmatics responded. Females constituted 63% of the respondents; mean age was 40.9 years; Malays were the majority ethnic group, while 70.8% had secondary level education and 53.7% were employed. Half had suffered from asthma for at least 13 years, while 46.8% and 23.6% have moderate and severe disease respectively. Quality of life was affected by severity of disease. Asthmatics, had a significantly poorer quality of life than the general US population. Severe asthma disease was associated with a compromised quality of life, similar to that of COPD.

Matched MeSH terms: Middle Aged

Fulltext Gender differences in the clinical and serological features of systemic lupus erythematosus in Malaysian patients

Azizah MR, Ainol SS, Kong NCT, Normaznah Y, Rahim MN

Med J Malaysia, 2001 Sep;56(3):302-7.

PMID: 11732074

An analysis of the clinical and serological features of 12 male and 122 female patients with SLE was done to determine whether sex related differences exist. We found a lower incidence of mucocutaneous symptoms and arthritis but an increased incidence of discoid lesions, pleuritis and pericarditis in males at disease onset. During the disease course, there was a lower incidence of arthritis, a similar prevalence of mucocutaneous symptoms but an increased incidence of pleuritis in males with a trend towards renal involvement. These findings were however not statistically significant except for the higher incidence of thrombosis among males. Serologically, both groups showed similar frequencies of autoantibodies and hypocomplementaemia. Although the study was small, it was shown that several sex-related differences in the clinical and serological features exist in Malaysian SLE patients.
Study site: SLE Clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia

Matched MeSH terms: Middle Aged

Fulltext Balloon endometrial thermoablation--an alternative management of adenomyosis with menorrhagia and dysmenorrhoea

Chan CLK, Annapoorna V, Roy AC, Ng SC

Med J Malaysia, 2001 Sep;56(3):370-3.

PMID: 11732085

A 45 years old Chinese housewife presented with menorrhagia and dysmenorrhoea due to adenomyosis failed to respond to various medical treatments. She was treated with balloon thermoablation. The total menstrual blood loss (MBL) decreased from 96.94 ml before to 37.57 ml, six months after thermoablation. The pictorial blood loss chart (PBLC) showed similar decrease in blood loss. Dysmenorrhoea was also cured. At three year follow up, there was no recurrence. This is the first report which shows thermoablation decreases MBL objectively and can be tried to treat adenomyosis.

Matched MeSH terms: Middle Aged

The value of transesophageal echocardiography in transcatheter closure of atrial septal defects in the oval fossa using the Amplatzer septal occluder

Latiff HA, Samion H, Kandhavel G, Aziz BA, Alwi M

Cardiol Young, 2001 Mar;11(2):201-4.

PMID: 11293739

BACKGROUND: From January, 1997, as part of an international multicentric trial, we have been closing small-to-moderate atrial septal defects within the oval fossa using the Amplatzer Septal Occluder (ASO, AGA Medical).

METHODS: All patients with defects within the oval fossa deemed potentially suitable for transcatheter closure were investigated by transesophageal echocardiography with the aim of gaining extra information that might alter the decision to use the device to close the defect. Views were obtained in transverse and longitudinal planes, permitting measurements of the diameter of the defect, and its distance from the atrioventricular valves, coronary sinus, and pulmonary veins. Additionally, we sought to identify multiple defects, and to exclude sinus venosus defects.

RESULTS: Of 56 patients with left-to-right shunts, 41 (73.2%) were deemed suitable for closure with the Amplatzer Septal Occluder. All underwent the procedure successfully, with no complications. This includes 5 patients with multiple small defects that were sufficiently close to the main defect to be closed with a single device. Only two of these had been detected on the transthoracic study. In the remaining 15 of 56 patients, transcatheter closure was deemed unsuitable. In 9 patients, this was due to the limitation of the size of the device available during the period of study, this representing a relative contraindication. In the remaining 6 (10.7%), transcatheter closure was not performed because multiple defects were too far apart to be closed with a single device in 3 patients, two patients were noted to have a sinus venosus defect, and another was noted to have anomalous connection of the right upper pulmonary vein to the right atrium. Excluding patients contraindicated due to the size of the defect alone, transesophageal echocardiography provided extra information in one-tenth of our patients, which altered the decision regarding management.

CONCLUSION: Transesophageal echocardiography is indispensable in the evaluation of patients undergoing transcatheter closure of atrial septal defect.

Matched MeSH terms: Middle Aged

Fulltext The effect of pesticide on the activity of serum cholinesterase and current perception threshold on the paddy farmers in the Muda agricultural development area, MADA, Kedah, Malaysia

Husin LS, Uttaman A, Hisham HJ, Hussain IHS, Jamil MRM

Med J Malaysia, 1999 Sep;54(3):320-4.

PMID: 11045057

The aim of this study was to find out the indicator as a marker of person who are exposed to pesticides (organophospate). Up to now the serum cholinesterase is used as a marker. This new method will not taking blood vein since this be the obstacle in conducting research in a rural area.

Matched MeSH terms: Middle Aged

Fulltext Asbestosis in Malaysia: report on first two cases

Lim HH, Rampal KG, Joginder S, Abu Bakar CM, Chan KH, Vivek TN

Med J Malaysia, 1999 Sep;54(3):364-7.

PMID: 11045065

The first two cases of asbestosis in Malaysia are reported. Both had considerable occupational exposure to asbestos dust in the past, with a long latency period exceeding 30 years. One case presented with distinctive clinical and radiological features, while the other case was only confirmed by histological diagnosis. The usefulness of modern investigation techniques such as CT scan in the diagnosis of asbestosis is also illustrated.

Matched MeSH terms: Middle Aged

Fulltext Secondary intraocular lens implantation in University Hospital, Kuala Lumpur

Jaais F

Med J Malaysia, 1998 Sep;53(3):272-6.

PMID: 10968165

Secondary intraocular lens implantation after cataract surgery done in University Hospital between 1983 to 1993 were reviewed. Thirty three patients (37 eyes) underwent secondary intraocular lens implantation during this period. Twenty four eyes had secondary anterior chamber lens implantation while 13 had posterior chamber lens implantation. There was no case of secondary posterior scleral fixation lens implantation. Visual acuity of 6/9 or better was seen in 25 of 37 eyes (67%) in the series. Eyes seeing as good or better than before secondary implantation procedure were noted in 34 of 37 eyes (92%). Vision of 6/9 or better was seen in 9 of 13 eyes (70%) with posterior chamber implants and 16 of 24 eyes in (67%) with anterior chamber lenses. Complications including bullous keratopathy, uveitis and glaucoma were seen with anterior chamber implants of the rigid type resulting in poorer visual acuity than before the secondary procedure.

Matched MeSH terms: Middle Aged

Fulltext The dimensions of ocular morbidity amongst the nursing home geriatrics population

Normalina M, Zainal M

Med J Malaysia, 1998 Sep;53(3):239-44.

PMID: 10968160

A cross-sectional prevalence study amongst a nursing home elderly population was carried out at Rumah Sri Kenangan, Seremban, Negeri Sembilan between June 1995 until June 1996. A total of 204 cases of 60 years and older were examined in order to determine the ocular morbidity amongst them. It was found that 47.5% had low vision and 19.1% were legally blind. Cataract was found to be the leading cause of low vision and blindness occurring in 81.4% and 74.3% respectively. Glaucoma occurred in 1% of those who had low vision and none due to macular degeneration or diabetic retinopathy. The magnitude of visual impairment and blindness in this nursing home is high but is preventable and avoidable.

Matched MeSH terms: Middle Aged

Fulltext Neural leprosy--a case report

Khaw GE

Med J Malaysia, 1998 Mar;53(1):114-6.

PMID: 10968151

Neural leprosy is rare. This is a report of a 63-year-old Indian man who had long standing multiple peripheral neuropathy. The slit skin smear for acid-fast bacilli of Mycobacterium leprae was positive. The skin and nerve biopsies were normal. He was treated with rifampicin, dapsone and clofazimine.

Matched MeSH terms: Middle Aged

Fulltext Day care percutaneous renal surgery--is this viable?

Chong WL, Murali S, Sahabudin RM, Khairullah A

Med J Malaysia, 2002 Mar;57(1):108-10.

PMID: 14569727

Pros and cons of Percutaneous Nephrolithotripsy (PCNL) versus Extracorporeal Shockwave Lithotripsy (ESWL) have often been highlighted when one discusses on the management of renal stones. An oft quoted point is that PCNL entails a prolonged hospital stay whereas ESWL sessions are day surgical in nature. However, PCNL has superior stone clearance rate as compared to ESWL especially for lower pole stones. In addition, PCNL is more suitable for large bulk stones and when ancillary procedures are required e.g. endopyelotomy. The first 50 cases of successful tubeless PCNL were reported by Bellman et al in 1997. The remarkable recovery of patients in their series encouraged them to employ this technique as their technique of choice for the majority of their cases. A similar technique was employed on endopyelotomy by Liang et al and they concluded that this was a safe, less morbid and effective technique. We report our first case of tubeless PCNL.

Matched MeSH terms: Middle Aged

Avulsed ureter

Dublin N, Razack AH

ANZ J Surg, 2003 Apr;73(4):254-5.

PMID: 12662241

Matched MeSH terms: Middle Aged

A 52-year-old woman with recurrent hemoptysis

Lim KH, Lim YC, Liam CK, Wong CM

Chest, 2001 Mar;119(3):955-7.

PMID: 11243981

Matched MeSH terms: Middle Aged

Fulltext Decompression illness associated with underwater logging: 6 case reports from Kenyir Lake, Malaysia

Loke YK, Tee MH, Tan MH

Med J Malaysia, 1998 Mar;53(1):100-3.

PMID: 10968146

The formation of Kenyir Lake as part of a hydroelectric project in the 1980s caused much forest area to be submerged. From 1991, underwater divers were employed to log these sunken trees at depths of up to 100 meters. At least 6 mishaps involving underwater logging personnel were recorded from March 1994 to August 1996. We retrospectively reviewed 5 cases who were managed in Hospital Kuala Terengganu. The patients presented with marked cardiorespiratory and neurological disturbances. One diver died in the Hospital while another died at the recompression chamber. Three divers were treated with recompression and improved. Average delay before the start of recompression was 14 hours. Underwater logging has definite dangers and steps must be taken to ensure that both the divers and the equipment are appropriate for the task. Availability of a nearby recompression facility would greatly enhance the management of diving accidents, not only for commercial divers but also for recreational divers who frequent the islands nearby.

Matched MeSH terms: Middle Aged

Fulltext Blindness and visual impairment amongst rural Malays in Kuala Selangor, Selangor

Zainal M, Masran L, Ropilah AR

Med J Malaysia, 1998 Mar;53(1):46-50.

PMID: 10968137

A population-based cross-sectional study was carried out to determine the prevalence of visual impairment and blindness and its causes amongst the adult rural Malay population in the district of Kuala Selangor, Selangor. By simple random sampling 330 samples were selected for the study. All samples underwent complete ophthalmological examination. The crude prevalence of visual impairment and blindness were 0.7% and 5.6% respectively. Age was the most important factor associated with the prevalence; gender, level of education and level of income was not significantly related. Cataract was the commonest cause of visual impairment and blindness while diabetic retinopathy was the second important cause.

Matched MeSH terms: Middle Aged

Fulltext A hospital based study of cancer admissions

Hooi LN, Devaraj T

Med J Malaysia, 1998 Mar;53(1):22-9.

PMID: 10968133

A study was done on patients admitted to Penang Hospital with malignant disease in 1995. A total of 1333 patients (638 male, 695 female) with 1335 malignancies were studied. The majority (77.3%) were aged 41-80 years. The commonest cancers in males were cancers of lung, nasopharynx, colon and rectum, leukemia and larynx whereas the commonest malignancies in females were of the breast, cervix, colon and rectum, leukemia and ovarian/lung carcinoma. The average number of admissions was 2.2 and the average length of stay was 12.7 days. Cancer admissions account for a significant proportion of the inpatient workload of Penang Hospital.

Matched MeSH terms: Middle Aged

Fulltext An analysis of glaucoma patients seen at the General Hospital Kuala Lumpur over a five year period: 1986 to 1990

Selvarajah S

Med J Malaysia, 1998 Mar;53(1):42-5.

PMID: 10968136

The records of all the glaucoma patients seen at the General Hospital Kuala Lumpur over a five year period were analysed. The racial, age and sex distribution of patients with primary open angle glaucoma and primary angle closure glaucoma was determined. The causes of secondary glaucoma were analysed. As no previous records of glaucoma statistics are available in Malaysia, it is hoped that these findings will form an initial mosaic to build on in the future.

Matched MeSH terms: Middle Aged

Fulltext Pancreatic tuberculosis presenting with recurrent acute pancreatitis

Redha S, Suresh RL, Subramaniam J, Merican I

Med J Malaysia, 2001 Mar;56(1):95-7.

PMID: 11503305

Tuberculosis, in its extrapulmonary form, though emerging as a common clinical problem, rarely affects the pancreas. Its indolent course, vague symptomatology along with its non-specific laboratory and radiographic findings call for greater vigilance. We report a case of pancreatic tuberculosis, previously managed as recurrent alcohol related pancreatitis which showed symptomatic improvement following commencement of antituberculosis drugs. The diagnosis of pancreatic tuberculosis in this case was based on the abdominal CT scan findings, response to anti-tubeculous chemotherapy and overall laboratory and radiological work-up.

Matched MeSH terms: Middle Aged

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