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  1. Chu ECP, Lo FS, Bhaumik A
    J Family Med Prim Care, 2019 Nov;8(11):3742-3744.
    PMID: 31803683 DOI: 10.4103/jfmpc.jfmpc_839_19
    Dermatomyositis (DM) is an idiopathic inflammatory myopathy characterized by progressive muscle weakness and pathognomonic skin eruptions. Systemic corticosteroid with or without an immunosuppressive agent is the current treatment of choice in most cases. Cutaneous disease in DM is often refractory and can become the most challenging component to manage effectively. Here, we report a case of recalcitrant DM in a 66-year-old female who sought chiropractic attention for recent episodes of pain and paresthesia in the neck and exacerbation of joint pain. As expected, the musculoskeletal complaints including neck pain, peripheral arthralgia, and muscle weakness that resolved within 1 month after starting treatment. Unexpectedly, dramatic remission of the characteristic skin rashes occurred concurrently. The underlying therapeutic mechanisms of chiropractic remain elusive. This case highlights the importance of family physicians becoming familiar with diagnosing the condition and using a multidisciplinary team approach to treat recalcitrant DM.
    Matched MeSH terms: Neck Pain
  2. Anwar A, Chan KMJ, Awang Y, Ping DC
    Med J Malaysia, 2019 Oct;74(5):436-438.
    PMID: 31649223
    Anomalous Aortic Origin of a Coronary Artery (AAOCA) is a rare anomaly of the coronary artery with a considerable risk of sudden cardiac death due to ischaemia of the heart. Symptoms may include chest pain on exertion, breathlessness or dizziness. We encountered a case of a 46- year-old female who complained of exertional chest pain with a positive-stress test and subsequently diagnosed with AAOCA through CT angiography (CTA). She successfully underwent a coronary artery bypass graft (CABG) surgery using a saphenous vein graft with uneventful recovery. Right internal mammary artery (RIMA) was not used as it was flimsy and the flow was very poor.
    Matched MeSH terms: Chest Pain
  3. Muhammad Adil ZA, Nur Zawani J, Hazariah AH, Rao G, Zailiza S, Mohd Nasir H
    Med J Malaysia, 2019 Oct;74(5):413-417.
    PMID: 31649218
    INTRODUCTION: A methanol outbreak occurred in the district of Hulu Langat on 16 September 2018. The Hulu Langat District Health Office received 25 notifications of a suspected methanol poisoning from Kajang and Ampang Hospital. An outbreak investigation was done to determine the source followed by a preventive and control measure.

    METHOD: Active case detection was done on cases living quarters and workplaces. Patients were interviewed, and their blood and urine samples were sent for methanol analysis. Samples of suspected alcoholic beverages were also sent for analysis. A suspected case was defined as any person presented with clinical symptoms with a history of consuming alcoholic beverages within five days before symptoms and high anion gap metabolic acidosis. A confirmed case was defined as a suspected case with positive blood and urine methanol.

    RESULTS: In total, there were 25 suspected cases, of which 12 cases were confirmed. The calculated attack rate was 48%. There were six mortalities (50%) secondary to severe metabolic acidosis. The most common presenting symptom was vomiting (75%) and abdominal pain (41.7%). These cases were linked to consumption of illicitly produced alcohol. Samples of the alcoholic drinks were positive containing high level of methanol.

    CONCLUSION: The methanol outbreak in the Hulu Langat was successfully managed. Appropriate control and prevention measures were taken, including health promotion and joint enforcement activities. Steps were taken successfully through collaborations with multiple agencies and cooperation with Selangor Health Departments and the Ministry of Health. Continuous surveillance on the product of liquor, and health promotion are essential to prevent a similar outbreak from happening again in future.

    Matched MeSH terms: Abdominal Pain
  4. Mayaki AM, Intan-Shameha AR, Noraniza MA, Mazlina M, Adamu L, Abdullah R
    Vet World, 2019;12(3):377-381.
    PMID: 31089306 DOI: 10.14202/vetworld.2019.377-381
    Background and Aim: Back disorder is an ailment that often affects athletic and riding horses. Despite the rapidly growing equine athletic and equestrian activities, there is no documentation on the nature of equine back disorder (EBD) in Malaysian horses. The purpose of this study was to characterize EBD cases presented to University Veterinary Hospital, Universiti Putra Malaysia, between 2002 and 2017.

    Materials and Methods: The compilation of data was based on signalment, case history, duration of clinical signs, anatomical location of the pain, method of diagnosis, type of EBD, treatment, and outcome. The diagnosis of EBD was based on a history of poor performance, clinical examination findings, radiography, and, where applicable, necropsy.

    Results: A total of 181 diagnosed cases of EBDs were identified. The age of horses ranged from 5 to 22 years. The EBD cases were more prevalent in male than female horses and predominantly in geldings (60.77%). Thoroughbred, Arab, Polo pony, and Warmblood also recorded the most EBD cases among breeds. The discipline of horses tended to influence the development of EBDs, with patrolling horses recording the highest frequency. Most EBD cases were of the primary type (92.27%), with the main causes being soft-tissue lesions (57.48%), vertebral lesions (18.56%), tack-associated problems (16.77%), and neurological lesions (7.19%). The common treatments employed were administration of nonsteroidal anti-inflammatory agents, 1 to 3-month rest, warm and cold compression therapy, massage therapy, exercise adjustment, as well as correction of ill-saddle fit.

    Conclusion: Most EBDs in this study were associated with soft-tissue lesions. Among vertebral lesions, kissing spines were the most common cause of EBDs in horses in Malaysia.

    Matched MeSH terms: Pain
  5. Norhayati Ibrahim, Norella Kong Chiew-Thong, Asmawati Desa, Rozmi Ismail
    Sains Malaysiana, 2015;44:599-605.
    This cross-sectional study examined the influence of illness perception of health-related quality of life (HRQoL) in end
    stage renal disease (ESRD) patients on either hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD).
    The Short Form-36 (SF-36) was used to measure HRQoL which comprised the Physical Component Summary (PCS) and
    Mental Component Summary (MCS). Illness perception was evaluated using Revised Illness Perception Questionnaire
    (IPQ-R). Both questionnaires were administered on 183 HD and 93 CAPD patients. The results showed that almost all
    HRQoL subscales except physical functioning and bodily pain were found to be significantly different between HD and
    CAPD patients. There are significant correlations between most components of illness perception with HRQoL. Significant
    illness perception predictors of PCS among HD patients were time line, consequences, cyclical and identity, whereas on
    CAPD patients were time line, illness coherence, emotional, cyclical and identity. Significant illness perception predictors
    of MCS among HD patients included time line, cyclical and identity and only time line was significant predictor of MCS on
    CAPD patients. These should be considered when developing intervention programmes to improve their HRQoL.
    Matched MeSH terms: Pain
  6. Farah Syaza Rahman, Nurlia Yahya, Nor Mohammad Md Din, Azarinah Izaham, Wan Rahiza Wan Mat
    MyJurnal
    Introduction: Non-pharmacological interventions are considered as successful adjuncts to manage pain. We are studying the comparative effects of listening to prayer recitation and music therapy intraoperatively as non-pharmacological interventions on postoperative pain and intraoperative haemodynamics. Materials and Methods: Seventy two muslim patients with acute appendicitis requiring open, emergency appendicectomies under general anaesthesia were recruited and randomised into three groups: Group A: patients who listened to prayer recitation, Group B: patients who listened to music, Group C: control group - patients who did not listen to any prayer or music. Intraoperative blood pressure, heart rate and postoperative pain scores were monitored. Results: The demographic data, pre- and post-headphones application haemodynamics were compared. There were significantly lower heart rates at 10, 20, 30, 40, 50, 60 minutes for Group A and at 50 and 60 minutes for Group B patients when compared to Group C. Significant reduction in postoperative pain scores were seen in Group A patients at 30 minutes and 8 hours as compared to Group C patients. No significant differences in pain scores were seen between Group B and C patients. No significant differences in additional analgesic requirements postoperatively were seen in all three groups. Conclusion: Listening to prayer recitation or music intraoperatively significantly lowered intraoperative heart rates, however only prayer recitation significantly reduced postoperative pain scores as compared to the control group.
    Matched MeSH terms: Pain, Postoperative
  7. Kamudin NAF, Rani RA, Yahaya NHM
    J Clin Orthop Trauma, 2018 11 20;11(1):171-174.
    PMID: 32002008 DOI: 10.1016/j.jcot.2018.11.007
    Pes anserine syndrome is a cause of inferomedial knee pain. It occurs in patients with diabetes mellitus, osteoarthritis, rheumatoid arthritis and in overweight patients. It is a challenge to identify the causes of knee pain following knee replacement surgery. We present a case report of pes anserine syndrome in a 79-year-old female who had undergone knee arthroplasty 13 years prior. She was pain free until one year ago when her knee pain resurfaced without any symptoms of infection or history of trauma. She was successfully treated with a combination of stretching exercise and steroid local steroid injection. We want to highlight that such common condition as pes anserine syndrome, could occur in total knee arthroplasty, and should be considered as one of the possible diagnosis.
    Matched MeSH terms: Pain
  8. Pande K, Aung TT, Leong JF, Bickle I
    Malays Orthop J, 2017 Mar;11(1):77-78.
    PMID: 28435582 DOI: 10.5704/MOJ.1703.012
    Transient osteoporosis of the hip (TOH) is a benign, selflimiting condition characterised by acute onset groin pain in adults. Early diagnosis is important to differentiate it from progressive conditions such as osteonecrosis. We report on a middle-aged male who presented with right groin pain without any prior trauma. The diagnosis of transient osteoporosis of hip was confirmed by Magnetic Resonance Imaging (MRI) and he was successfully treated with a course of Alendronate sodium, anti-inflammatory analgesics and a period of non-weight bearing ambulation.
    Matched MeSH terms: Acute Pain
  9. Johari HH, Khaw BL, Yusof Z, Mohamad I
    World J Clin Cases, 2016 Nov 16;4(11):375-379.
    PMID: 27900327
    Foreign body (FB) ingestion is very common in Malaysian population. The most commonly ingested FB is fish bone. Common presenting symptoms include FB sensation, odynophagia and or sharp pricking pain during swallowing. A careful history and physical examination is very important. Despite negative laryngoscopy and rigid esophagoscopy, persistent symptoms warrants further radiographic imaging studies. The FB can migrate extraluminally and involve other important adjacent structures of the neck and along the digestive tract. We report 3 cases of extraluminal migration of fish bone and their complications, which were successfully managed. One case with vascular complication which involve common carotid artery and the other two cases with neck abscess formation involving thyroid gland, retropharyngeal and parapharyngeal abscess.
    Matched MeSH terms: Pain
  10. Tan T, Ho W
    Malays Orthop J, 2015 Nov;9(3):65-67.
    PMID: 28611915 DOI: 10.5704/MOJ.1511.010
    Stress fractures of the proximal tibia metaphysis are rare in the elderly. We present a case of a 65-year old male who developed sequential proximal tibia stress fractures associated with prolonged usage of methotrexate and prednisolone within a span of 18 months. Magnetic Resonance Imaging revealed an incomplete stress fracture involving the medial proximal tibial region. The patient was treated with stemmed total knee arthroplasty (TKA) bilaterally. Stress fractures should be considered in patients with atypical knee pain who have a history of methotrexate and prednisolone usage. TKA is an effective treatment in stress fractures of the proximal tibia.
    Matched MeSH terms: Pain
  11. Ng YM, Voo P, Maakip I
    BMC Public Health, 2019 Feb 26;19(1):234.
    PMID: 30808335 DOI: 10.1186/s12889-019-6553-3
    BACKGROUND: One of the occupations that suffer from musculoskeletal disorders (MSD) is the teaching profession. Although teachers are known to have a variety of health and safety issues, few studies have actually been published that relate to somatic health problems of teachers, especially studies conducted in Malaysia. From this viewpoint, it is clearly important to investigate psychosocial factors, and MSD with depression as mediator among school teachers.

    METHODS: The study aimed to determine the incidence of MSD for school teachers in 15 primary schools in Kuala Lumpur during a 6-month period. Secondly, the study also sought to examine the relationships between psychosocial factors, depression and MSD among teachers. Thirdly, the study aimed to explore depression as mediator. The hypothesis addressed by this cross-sectional study was that depression would prove to be a mediator for the psychosocial factors affecting MSD.

    RESULTS: The incidence of MSD during the previous 6 months was 80.1% (95% CI: 75.8-84.2%), with 80.5% of female and 77.5% of male teachers reporting symptomatic pain during that period. There were significant relationships between psychosocial factors, depression, and MSD. The results indicated that in relation to psychosocial factors, depression (r = - 0.25, p 

    Matched MeSH terms: Pain
  12. Kapil Mani KC, Dirgha Raj RC, Parimal A, Ram PB
    Malays Orthop J, 2016 Nov;10(3):56-57.
    PMID: 28553452 DOI: 10.5704/MOJ.1611.011
    Old neglected dislocation of knee joint is a rare injury. Any orthopaedic surgeon would have faced only a few cases of unreduced neglected dislocation in his life time practice. We report the case of a 30-year old male patient with one month old unreduced knee dislocation which was managed with open reduction and stabilization with two intra-articular crossed Steinman pins for six weeks, followed by removal of the pins and gradual weight bearing in hinged knee brace. At the end of one year, range of movement of knee joint was 0 to 50 degree with minimal knee pain on walking.
    Matched MeSH terms: Pain
  13. Afshar A, Tabrizi A
    Malays Orthop J, 2017 Nov;11(3):45-46.
    PMID: 29326766 DOI: 10.5704/MOJ.1711.002
    A 30-year old male right handed professional tennis player complained about reduced athletic performance, chronic pain and restricted extension of his right wrist. Lateral radiograph of the right wrist demonstrated an osteophyte projecting from the dorsal lip of the lunate bone. The presence of an osteophyte on the lateral radiograph of the lunate along with the history, clinical examination, intra-operative findings, and post-operative satisfactory result made the diagnosis of dorsal luno-capitate impingement syndrome reasonable.
    Matched MeSH terms: Chronic Pain
  14. Abdullah D, Syed Mohamed AMF, Cheen Liew AK
    J Conserv Dent, 2019 3 2;22(1):102-106.
    PMID: 30820092 DOI: 10.4103/JCD.JCD_113_18
    Although corticosteroid provides many clinical benefits, it may cause a range of side effects. A 47-year-old female patient presented with a complaint of pain from her teeth, triggered upon taking cold, hot, and sweet food and drink. From her medical history, she was previously diagnosed with ulcerative colitis. She consequently developed pyoderma gangrenosum, and high-dose prednisolone was administered to treat this condition (prednisolone 30 mg bd for 4 months followed by tapering dose 5 mg/week). She claimed the pain started at the end of steroid therapy. The pain mimicked symptoms of dentine hypersensitivity, but without the presence of the clinical signs associated with hypersensitivity, suggesting that the pain was steroid induced. Patients in this condition will find that their dietary choices will be limited and effective oral hygiene be impeded. Reassurance and advising patients to maintain oral hygiene are the most appropriate treatment as this condition would eventually wear off with time.
    Matched MeSH terms: Pain
  15. Mohd Rashid MZ, Sapuan J, Abdullah S
    J Orthop Surg (Hong Kong), 2019 3 12;27(1):2309499019833002.
    PMID: 30852960 DOI: 10.1177/2309499019833002
    BACKGROUND:: Trigger finger release utilizing wide-awake local anesthesia no tourniquet (WALANT) usage in extremity surgery is not widely used in our setting due to the possibility of necrosis. Usage of a tourniquet is generally acceptable for providing surgical field hemostasis. We evaluate hemostasis score, surgical field visibility, onset and duration of anesthesia, pain score, and the duration of surgery and potential side effects of WALANT.

    METHODS:: Eighty-six patients scheduled for trigger finger release between July 2016 and December 2017 were randomized into a control group (1% lignocaine and 8.4% sodium bicarbonate with arm tourniquet; given 10 min prior to procedure) and an intervention group (1% lignocaine, 1:100,000 of adrenaline and 8.4% sodium bicarbonate; given 30 min prior to procedure), with a total of 4 ml of solution injected around the A1 pulley. The onset of anesthesia and pain score upon injection of the first 1 ml were recorded. After the procedure, the surgeon rated for the hemostasis score (1-10: 1 as no bleeding and 10 being profuse bleeding). Duration of surgery and return of sensation were recorded.

    RESULTS:: Hemostasis score was grouped into visibility score as 1-3: good, 4-6: moderate, and 7-10: poor. The intervention group (with adrenaline) had a 74% of good surgical field visibility compared to 44% from the controlled group (without adrenaline; p < 0.05). Duration of anesthesia was longer in the intervention group (with adrenaline), with a 2.77-h difference.

    CONCLUSION:: WALANT provides excellent surgical field visibility and is safe and on par with conventional methods but without the usage of a tourniquet and its associated discomfort.

    Matched MeSH terms: Pain
  16. Yeow GPV, Yeow DGE, Sankaran P, Maiyauen T, Sharif MS
    Ann Hepatobiliary Pancreat Surg, 2019 Feb;23(1):77-79.
    PMID: 30863813 DOI: 10.14701/ahbps.2019.23.1.77
    The recurrence of hepatocellular carcinoma (HCC) can mainly be divided into two phases or types: the intrahepatic recurrence (IHR) and the extrahepatic recurrence (EHR). Generally speaking, the EHR is usually referenced as being the less common of the two types or categories. In a post-hemihepatectomy patient with routine surveillance at 6 months, it was noted that the patient appeared to have an elevated alpha-fetoprotein, and also complained of vague lower abdominal pain. The accompanying computed tomography scan revealed a 6 cm-sized heterogeneous mass located at the pelvis region. Next, during a laparotomy for resection, the tumor was found to be bleeding from the omental deposition. In conclusion, a high index of suspicion and early surgical intervention can help in detecting possible bleeding extrahepatic recurrence in the background of a patient with history of HCC.
    Matched MeSH terms: Abdominal Pain
  17. Tan K, Kwek E
    Malays Orthop J, 2020 Mar;14(1):24-27.
    PMID: 32296478 DOI: 10.5704/MOJ.2003.004
    Introduction: Orthopaedic surgeons are significantly predisposed to musculoskeletal injury, and these injuries can have negative effects on surgeon function and patient outcomes. While this phenomenon has been studied in the non-Asian population of surgeons, no study has been carried out in the local or regional Asian setting. The aim of this study was to determine the prevalence, characteristics and associations of occupational injuries in orthopaedic surgeons and residents, and to assess its functional impact.

    Materials and Methods: The Nordic Musculoskeletal Questionnaire was sent out to all orthopaedic consultants and residents at two institutions in Singapore, via an email link to an online survey. Separately, further questions on symptom description, severity and treatment were surveyed. Additional information like age, gender, height and weight were obtained as well.

    Results: A total of 87.5% respondents have at least one injury. Neck symptoms (66.1%) were the most prevalent, and back symptoms had the highest median severity score (4.5/10). The 74.1% of these injuries were reported as directly attributable to work. Age was found to be associated with an increase in the total number of anatomical areas affected (p = 0.016). A seated operating position was associated with more severe back pain (p = 0.040).

    Conclusion: There is a high prevalence of occupational injuries sustained in our population of orthopaedic surgeons. Neck symptoms, followed by back and wrist symptoms, were the predominant symptoms in our population. Targeted ergonomic interventions may be considered to prevent specific musculoskeletal injuries in our population of orthopaedic surgeons.

    Matched MeSH terms: Back Pain
  18. Ong TK
    Eur Endod J, 2019;4(3):145-149.
    PMID: 32161902 DOI: 10.14744/eej.2019.03016
    A 27-year-old male patient complained of dental pain on previously root-treated tooth #17. Intentional replantation (IR) was performed. However, the symptoms returned at 10 months of follow-up, and a sinus tract was detected on the buccal gingiva of tooth #17. The patient refused extraction of the tooth and tooth was scheduled for non-surgical retreatment. Root canal retreatment was initiated with the removal of the previous root filling material while leaving the retrograde filling in situ. After 1 month of intracanal medication, the tooth became asymptomatic with complete healing of the sinus tract and the root canal filling was completed. Clinical and radiographic examination at 1 year follow-up revealed endodontic success with complete resolution of periapical radiolucency. This case report shows that non-surgical retreatment could be a viable alternative for failed IR.
    Matched MeSH terms: Pain
  19. Swarna Nantha Y, Yeoh MH, Sharif SM
    Malays Fam Physician, 2019;14(3):60-64.
    PMID: 32175042
    Langerhans cell histiocytosis (LCH) in adults is rare and regarded as an 'orphan disease.' The systemic symptoms of LCH can mimic many other undifferentiated diseases seen at the primary care level. Failure to diagnose and delays in referral are common pitfalls in the management of this disease. We present a case of a 34-year-old woman with referred knee pain who was eventually diagnosed with multi-system LCH 4 years after the initial presentation. The mean age of presentation of LCH symptoms in adults is 33. Bone lesions are the frequent presentation of LCH in this age group. Endocrine involvement in LCH is seen in the form of diabetes insipidus (DI), which remains the most common extraskeletal presentation of LCH in adults. In the case discussed here, a definitive diagnosis of LCH was established through tissue biopsy. The spectrum of undifferentiated symptoms underscores the difficulty and delay in making a diagnosis associated with the condition. Most GPs not only face the predicament of initial recognition but also fail to merge presenting symptoms to form a purposeful referral of this elusive disease to a tertiary care unit.
    Matched MeSH terms: Pain
  20. Kia ACL, Dalia Abdullah, Seong JS, Chiang SC, Pau A
    A validated screening tool for patient triage based on the pain symptoms, could potentially optimize the resources and expertise available in dental pain management. The aim of this study was to translate and validate the Modified Dental Pain Questionnaire (M-DePaQ) for use in categorizing patients with pain into three groups of common dental conditions. Forward Malay and Chinese translation was performed, followed by backward English translation. The translation was reviewed by an expert panel and pre-tested on patients who are native speakers.Consecutive patients aged 18 years and older experiencing pain and attending the primary dental care clinic completed the questionnaires. Four calibrated dentists made clinical diagnoses independent of the questionnaire responses. For data analysis, the cases were split randomly into Random Sample 1 (RS1) and Random Sample 2 (RS2). Discriminant analysis was performed on RS1 to develop a model for classifying dental pain cases into three groups. The model was applied to cases in RS2, and a cross-validated accuracy rate was obtained. Criterion validity was assessed using measures such as sensitivity, specificity, positive predictive value, and kappa. Of the 234 questionnaires distributed, 216 (92.3%) were returned. Classification rates were recorded at 73.8% for RS1, 75.0% for RS2, and 71.1% for all cases. The sensitivity values were 0.72, 0.39, and 0.43 for Groups 1, 2, and 3, respectively. The corresponding specificity values were 0.42, 0.87, and 0.94. The discriminant validity of the adapted questionnaire was satisfactory, but the criterion validity could not be established because of biases incorporated in the study.
    Matched MeSH terms: Pain Management
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