MyMedR

Fulltext Endoscopic pneumatic balloon dilatation for achalasia of the cardia

Ding PH

Med J Malaysia, 1995 Dec;50(4):339-45.

This study evaluated the efficacy and safety of endoscopic pneumatic balloon dilatation as the initial treatment for achalasia of the cardia. 15 patients with achalasia underwent a total of 19 dilatations using the new polyethylene dilator (Microvasive Rigiflex Balloon Dilator) over the last 6 years. An overall treatment success rate of 93% was achieved. 11 patients (73.3%) have not required a further dilatation and 3 patients (20%) required between 1 and 2 further dilatations. Elective surgery was necessary in 1 patient. The mean follow-up period was 31.5 months. There was no complication or death attributable to the procedure. Endoscopic pneumatic balloon dilation is a safe and effective treatment for achalasia and should be considered as the initial treatment of choice in most patients with achalasia.

Matched MeSH terms: Middle Aged

Fulltext Progression of myopia in different ethnic groups in Malaysia

Yeow PT

Med J Malaysia, 1994 Jun;49(2):138-41.

PMID: 8090092

A cross-sectional study on a normal clinical myopic population reveals that there is a difference in the pattern of myopic progression between Malays and Chinese in Malaysia. It shows that while myopia in Malays stays relatively constant throughout 10 to 50 years of age, myopia in Chinese progresses rapidly from 10 to 20 years of age, after which it starts to show hyperopic shift, reaching a level of myopia similar to that of Malays at around 35 years of age. In view of the above finding it is postulated that the difference in myopia between the two races may be due to excessive accommodation in Chinese, causing a temporary increase in crystalline lens power and hence an increase in myopia. Because the magnitude of myopia for both races for 10 +/- 1 years age group is relatively high, i.e. about -2.00 D, it is postulated that myopia in these ethnic groups may start much earlier than 10 years of age.

Matched MeSH terms: Middle Aged

Fulltext Migrating foreign body--an unusual presentation

Krishnan G

Med J Malaysia, 1994 Jun;49(2):169-71.

PMID: 8090097

A case report of an ingested fish bone migrating to the subcutaneous tissue in the neck is presented. During its course of migration there was no significant morbidity. The usual management is to locate the foreign body and remove it. A review of the literature indicates that this is evidently a rare case.

Matched MeSH terms: Middle Aged

Fulltext Low birth weight incidence in Lundu, Sarawak

Yadav H

Med J Malaysia, 1994 Jun;49(2):164-8.

PMID: 8090096

The overall mean birth weight of the total deliveries (1986-1988) in Lundu Hospital was 2.96 kg. The mean birth weight for the male babies was 2.94 kg. The Chinese babies had a significantly higher mean birth weight (3.12 kg) than the other ethnic groups (p < 0.05). The overall incidence of low birth weight (LBW) in this study was 11.84 per cent. The Chinese again had a lower incidence of LBW of 6.73 per cent compared to Ibans who had the highest incidence of LBW, 13.59 per cent, with the Bidayuhs 12.97 per cent and Malays, 12.45 per cent. It was also noticed that of the 14.9 per cent preterm deliveries, 37.5 per cent were LBW. The very young mothers (15-19 years) and older mothers (> 40 years) seem to have a higher incidence of LBW. Mothers who had medical conditions like anaemia, hypertension, pre-eclampsia also had a higher incidence of LBW when compared to mothers who did not have a medical condition. Special emphasis should be given to mothers who have medical conditions, and to very young and very old mothers during antenatal care, to prevent incidence of LBW.
Comment in: Chia CP. Low birth weight babies. Med J Malaysia. 1995 Mar;50(1):120

Matched MeSH terms: Middle Aged

Autokeratoplasty in a developing country

Shriwas SR, Reddy TN

Trop Doct, 1993 Oct;23(4):168-9.

PMID: 8273161

Matched MeSH terms: Middle Aged

Fulltext Epidural buprenorphine and bupivacaine in major gynaecological operations

Loh SP

Med J Malaysia, 1993 Jun;48(2):207-10.

PMID: 8350797

Eight patients underwent major gynaecological operations. Their post-operative analgesia was provided by epidural buprenorphine 0.15 mg and bupivacaine 0.5%. The efficacy and side-effects of this combination were assessed. All patients had satisfactory analgesia ranging in duration from 10 hours to greater than 36 hours after a single dose injection. No significant side-effect was noted.

Matched MeSH terms: Middle Aged

Fulltext Fibreoptic intubation--a case series and brief review

Tan I, Wang CY

Med J Malaysia, 1993 Jun;48(2):200-6.

PMID: 8350796

Fibreoptic intubation has been established as a major advance in the management of difficult or failed intubation in the awake patient. If necessary, it may be performed under general anaesthesia with either spontaneous or controlled ventilation. This should be considered early in the management of failed intubation, before multiple attempts with other techniques lead to haemorrhage and oedema in the airway. We describe here selected case reports to illustrate this in 8 different situations. This is followed by a brief review of the technique and indications of fibreoptic intubation.

Matched MeSH terms: Middle Aged

Fulltext Fertility following reversal of female sterilization

Rachagan SP, Jaafar Y

Med J Malaysia, 1993 Jun;48(2):225-8.

PMID: 8350801

This retrospective study presents data from 26 women who underwent a reversal of female sterilization. The intrauterine pregnancy rate and ectopic pregnancy rate were 38.5% and 7.7% respectively. The most successful site of tubal anastomosis was isthmic-isthmic anastomosis. The importance of proper patient selection and factors that affect the success rate in attempted reversals are emphasised. The importance of microsurgical approach is highlighted.

Matched MeSH terms: Middle Aged

Fulltext Computed tomography (CT) of orbital pseudotumour

Zulfiqar A, Abdul-Samad S, Alias D, Norizan A

Med J Malaysia, 1993 Jun;48(2):160-5.

PMID: 8350791

Orbital pseudotumour is a non-specific inflammatory disease. Its highly variable clinical and radiographic presentation makes specific diagnosis difficult. This study on 31 proven cases of pseudotumour shows that unilateral involvement, retroorbital fat infiltration and enlargement of multiple extraocular muscles with involvement of the tendinous insertions are key computed tomography CT features which help to establish the diagnosis of orbital pseudotumour.

Matched MeSH terms: Middle Aged

Radiological parameters of bleeding renal angiomyolipoma

Koh KB, George J

Scand. J. Urol. Nephrol., 1996 Aug;30(4):265-8.

PMID: 8908645

Angiomyolipomas are rare tumours of the kidney which have a tendency to bleed. We studied the clinical and radiological features of 11 patients from our institution to identify features which may be predictive of a massive haemorrhage. Tumours more than 6 cm in diameter were found to bleed and the demonstration of pseudoaneurysms on contrast CT scanning was associated with massive haemorrhage. We conclude that large angiomyolipomas should be treated to avoid haemorrhage and the detection of pseudoaneurysms should prompt urgent treatment.

Matched MeSH terms: Middle Aged

Pure-tone audiometry and auditory brainstem responses in noise-induced deafness

Noorhassim I, Kaga K, Nishimura K

Am J Otolaryngol, 1996 1 1;17(1):31-5.

PMID: 8801813

PURPOSE: The objective of this study is to find the relationship between pure-tone audiometry results and the auditory brainstem response wave abnormalities.

SUBJECTS AND METHODS: The pure-tone audiometry (PTA) and auditory brainstem responses (ABRs) from 22 patients (44 ears) with diagnosed noise-induced permanent hearing loss were studied. Three indices of PTA were average thresholds of 0.5 kHz/, /1 kHz, and 2 kHz (PTA1); 2 kHz and 4 kHz (PTA2); and 4 kHz (PTA3) were subdivided into 3 thresholds of hearing. Their relationships with ABR results were analysed. The patterns of PTA from various groups of ABR wave patterns were studied.

RESULTS: In this study, the abnormal ABR wave patterns were detected in 72.7% of the ears. The ears with prolonged ABR wave latency, absent early waves, prolong interpeak wave I-V latency was 20.5%, 18.2%, and 21.1%, respectively. Normal ABRs were recorded in 27.3% of the ears despite marked thresholds elevation of the PTA at high frequencies. Other relationships between PTA results and ABR wave results were discussed.

CONCLUSION: There were relationships between severity of noise-induced hearing loss indicated by PTA and the patterns of ABR wave abnormalities among workers with noise-induced permanent hearing loss.

Matched MeSH terms: Middle Aged

Fulltext Multimodal approach in the management of 1163 ureteric stone cases

Tan HM, Liew RP, Chan CC, Wong AT, Ngun KW

Med J Malaysia, 1995 Mar;50(1):87-92.

PMID: 7752983

One thousand one hundred and sixty three patients (male-852, female-311) with ureteric calculi requiring intervention were treated between April 1988 to July 1992. Four hundred and eleven cases were treated by ESWL Monotherapy, 414 by stone manipulation plus ESWL, 301 by retrograde ureteroscopic lithotripsy, 36 by percutaneous antegrade ureteroscopic lithotripsy and 1 case by open ureterolithotomy. There were 25 failures of the initial procedures. Only three cases that failed primary procedures required open surgery. Other complications include minor ureteric mucosal perforation (3%), infection (3%), transient moderate to gross haematuria (20%), loin ache (26.4%), irritative urination (34.4%) and low grade fever (30.1%). Current modalities used in the treatment of ureteric calculi produce good results and there is generally no primary role for any open surgery.

Matched MeSH terms: Middle Aged

Fulltext Immunogenicity of a plasma-derived hepatitis B vaccine in children and adults

Sinniah M, Halimah M, Krishnamurthy T, Lye MS, Choo CH, Shamsiah I

Med J Malaysia, 1994 Dec;49(4):336-40.

PMID: 7674968

Immunisation of health care workers and staff working in laboratory and hospital settings has been implemented since 1988. However due to the high cost of currently available HBV vaccine, many health personnel outside the Ministry of Health are not being immunised. This study sought to determine the immunogenicity of three doses of a low cost plasma-derived Korean HBV vaccine on employees of an institute for mentally handicapped and their spouses and children. We found that the Hepatitis B Vaccine-KGCC to be safe and immunogenic. The response to 10 mcg and 20 mcg Hepatitis B Vaccine-KGCC after third dose was good with 100% seroconversion.

Matched MeSH terms: Middle Aged

Four quadrant fine needle aspiration cytology for the detection of benign proliferative breast lesions accompanying breast carcinoma

Jayaram G, Gupta M, Lamba S

Malays J Pathol, 1993 Dec;15(2):137-42.

PMID: 8065175

Forty-eight patients with breast carcinoma were subjected to four quadrant fine needle aspiration (FNA) cytology examination of the ipsilateral and contralateral breast in an attempt to detect any accompanying benign proliferative lesion. Mastectomy of ipsilateral and open biopsy of contralateral breast provided material for histopathological study. Cytological evidence of epithelial proliferation was found in 8 (16.6%) cases which included atypical lobular hyperplasia (ALH), lobular neoplasia in-situ (LNIS), atypical ductal hyperplasia (ADH), and proliferative disease without atypia (PDWA). In lobular proliferative lesions, cytological smears showed configurations of cells that resembled filled up or expanded lobular units. The cytology was not distinctive enough to distinguish the sub-types of lobular proliferations. Likewise, the presence of ductal alterations could be suggested by cytological study but the distinction of proliferative disease without atypia (PDWA) from atypical ductal hyperplasia (ADH) was not possible on a cytological basis.

Matched MeSH terms: Middle Aged

Fulltext Gas-containing liver abscesses: assessment by ultrasound (US) and computed tomography (CT)

Samad SA, Zulfiqar MA, Maimunah A

Med J Malaysia, 1993 Mar;48(1):33-9.

PMID: 8341170

Single gas-containing pyogenic liver abscesses in 11 patients were studied by ultrasound and computed tomography (CT). On ultrasound, all abscesses were predominantly echogenic compared to the normal liver parenchyma. The gas collections appeared as hyperreflective areas arranged in clusters associated with acoustic shadowing and ring-down artifacts. Ten abscesses (90%) had ill-defined margins on ultrasound, causing underestimation of their sizes in these patients. All abscesses were shown to be multiloculated and had clearly defined borders on CT, not appreciated or mistaken for multiplicity of abscesses on ultrasound. Ultrasound may be inadequate in the evaluation of gas-containing liver abscesses, as they have complex echotexture in addition to ring-down artifacts, acoustic shadows and poorly-defined margins; leading to underestimation of abscess size, difficulty in identifying loculations and erroneous interpretation of multiplicity of abscess cavities.

Matched MeSH terms: Middle Aged

Fulltext The prevalence of endemic goitre in Kelantan, Malaysia

Mafauzy M, Wan Mohamad WB, Yasmin Anum MY, Musalmah M, Mustafa BE

Med J Malaysia, 1993 Mar;48(1):64-70.

PMID: 8341174

A large-scale study was undertaken in the state of Kelantan, to determine the prevalence of goitre. A total of 2,450 subjects above the age of 15 years were selected from 31 localities in the state and examination for goitre was done using the technique of Perez. The state was divided into 3 areas--coastal area (area 1), inland area (area 2) and the area in between the coast and the inland area (area 3). The overall prevalence of goitre was 36.8% and the prevalence in areas 1, 2 and 3 were 23.0%, 35.9% and 44.9% respectively and ranged from 6.9% in a locality in area 1 to 59.7% in a locality in area 3. In all areas, the prevalence was higher in females than in males. The prevalence of grades I, II and III goitres were 21.5%, 1.0% and 0.5% respectively in area 1, 33.6%, 1.5% and 0.7% respectively in area 2 and 41.7%, 2.2% and 1.0% respectively in area 3. Amongst age groups, goitre prevalence was highest in the 36 to 45 years age group in area 1 (33.9%), in the 15 to 25 years age group in area 2 (39.6%) and in the 26 to 35 years age group in area 3 (54.3%). In all the areas, goitre prevalence was lowest in the above 56 years age group. We concluded that the prevalence of goitre was high in Kelantan and there were regional differences in the prevalence rate within the state.

Matched MeSH terms: Middle Aged

Fulltext Comparative study of plain-film radiographs of maxillary sinuses between radiologists and clinicians

Krishnan G

Med J Malaysia, 1992 Sep;47(3):190-3.

PMID: 1491644

Maxillary sinuses plain film radiographs of 59 patients were reviewed and reported by both clinicians or Radiologists at the University Hospital, Kuala Lumpur. There was agreement in 52 reports of the plain film radiographs however there was partial differences in about seven cases. This gave an impression that the ENT specialist and the Radiologist were both capable of reporting plain film radiographs of maxillary sinuses, even though the radiologist has no opportunity of doing detail clinical examination of the patient.

Matched MeSH terms: Middle Aged

Fulltext Changing prevalence of diabetes mellitus amongst rural Malays in Kuala Selangor over a 10-year period

Khebir BV, Osman A, Khalid BA

Med J Malaysia, 1996 Mar;51(1):41-7.

PMID: 10967978

A cross-sectional study was carried out to determine the prevalence of diabetes mellitus and its relationship with age, physical activity, nutritional status and diet amongst rural Malays in Kuala Selangor. By simple random sampling 360 subjects were selected for the study. Besides guided questionnaires, subjects also underwent a 2 hours post prandial (2HPP) test to determine the diabetic status as recommended by WHO. The crude prevalence of diabetes mellitus was 14.6% which increases with age. The prevalence of diabetes adjusted for age was 12.2%. Physical activity status seemed to be a significant risk factor for diabetes. A greater proportion of diabetics was obese and their mean fat intake was higher than normal subjects (p < 0.05). The prevalence of diabetes mellitus in this study was significantly higher compared with data from 1984 (3.9%), representing a marked increment of 212.8 per cent over a 10-year period.

Matched MeSH terms: Middle Aged

Fulltext "Koro"-like syndrome affecting the tongue--a case report

Chin CN, S'ng KH

Med J Malaysia, 1995 Jun;50(2):175-7.

PMID: 7565190

A 52-year-old man presented with a 2-year history of episodic retraction of his tongue into the throat with a belief that he will die if the retraction is complete. The presentation is similar to koro except that the tongue is involved instead of the penis. It appears that retraction taxon can involve other organs and may not necessarily be culture bound.

Matched MeSH terms: Middle Aged

Fulltext Coronary heart disease mortality in peninsular Malaysia

Yusof SM, Margetts BM

Med J Malaysia, 1995 Jun;50(2):194-6.

PMID: 7565197

Matched MeSH terms: Middle Aged

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