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  1. Fulltext A rare case of massive systemic embolisation secondary to atrial myxoma- case report
    Muhammad Amin AU
    Med J Malaysia, 2013 Dec;68(6):471-2.
    PMID: 24632916
    We report a case of a 21 year old girl who presented with sudden onset of abdominal, back and bilateral leg pain, paralysis with unexpected collapse at home. Physical examination was suggestive of acute aortic occlusion. CTangiogram revealed multi-system thrombo-embolic shower. She proceeded to urgent aortic thrombectomy and fasciotomy of the bilateral lower limb. Further investigation revealed atrial myxoma and we report the patient's postoperative progress and eventual transfer to rehabilitation facility.
    Matched MeSH terms: Pain
  2. Chronic pain, impact of pain and pain severity with physical disability in older people--is there a gender difference?
    Hairi NN, Cumming RG, Blyth FM, Naganathan V
    Maturitas, 2013 Jan;74(1):68-73.
    PMID: 23103063 DOI: 10.1016/j.maturitas.2012.10.001
    To establish if there is any gender difference in associations between chronic pain, impact of pain and pain severity with physical disability.
    Matched MeSH terms: Pain Measurement
  3. Fulltext A comparison between subvastus and midvastus approaches for staged bilateral total knee arthroplasty:a prospective, randomised study
    Masjudin T, Kamari Zh
    Malays Orthop J, 2012 Nov;6(3):31-6.
    PMID: 25279053 DOI: 10.5704/MOJ.1207.0018
    This prospective randomised study was undertaken to compare surgical parameters as well as clinical and radiological outcomes of subvastus (SV) to midvastus (MV) approaches in staged bilateral total knee arthroplasty (TKA). Twenty-three patients, aged 55-76 years, who underwent staged bilateral TKAs, were followed up for 6 months. The SV approach was used on one knee and MV approach on the other. We found similar lateral retinacular release rates and patellar resurfacing rates between the two approaches .The SV approached knees had a more significant blood loss and increased operative time compared to the MV approached knees but they achieved significantly earlier active straightleg raises (SLR) postoperatively (p<0.05 for all). The average postoperative pain, flexion, and Knee Society scores were comparable for both approaches. TKA via SV vs. MV approaches provides comparable satisfactory short-term clinical and radiological outcomes, even though there was slightly more difficulty, more blood loss and longer operative times with the SV approach.
    Matched MeSH terms: Pain, Postoperative
  4. Non-cardiac chest pain: prevalence of reflux disease and response to acid suppression in an Asian population
    Mohd H, Qua CS, Wong CH, Azman W, Goh KL
    J Gastroenterol Hepatol, 2009 Feb;24(2):288-93.
    PMID: 19054255 DOI: 10.1111/j.1440-1746.2008.05702.x
    Gastroesophageal reflux disease is thought to be the commonest cause of 'non-cardiac chest pain'. The use of proton-pump inhibitors resulting in improvement in the chest pain symptom would support this causal association.
    Matched MeSH terms: Chest Pain/ethnology*; Chest Pain/etiology; Chest Pain/prevention & control*
  5. Antinociceptive and antiinflammatory activities of the aqueous extract of Trigonopleura malayana resin in experimental animal models
    Sulaiman MR, Zakaria ZA, Kamaruddin A, Meng TF, Ali DI, Moin S
    Methods Find Exp Clin Pharmacol, 2008 Nov;30(9):691-6.
    PMID: 19229377 DOI: 10.1358/mf.2008.30.9.1305824
    Trigonopleura malayana L. (Euphorbiaceae) resin, locally known as Gambir Sarawak, has been used traditionally to alleviate pain associated with insect bites, muscle ache, toothache and minor injuries. The present study was carried out using various animal models to determine the antinociceptive and antiinflammatory activities of the T. malayana resin aqueous extract. Antinociceptive activity was measured using the abdominal constriction, hot plate and formalin tests, while antiinflammatory activity was measured using the carrageenan-induced paw edema test. The extract, obtained after 24 h of soaking the dried resin in distilled water, was prepared in doses of 0.3, 3 and 10 mg/kg and administered subcutaneously 30 min prior to the assays. The mechanism of action was also determined by prechallenging with naloxone (10 mg/kg), a nonselective opioid antagonist. The extract was found to exhibit significant (P < 0.05) and dose-dependent antinociceptive and antiinflammatory activities; naloxone failed to inhibit the former activity. In conclusion, the aqueous extract of T. malayana resin possesses nonopioid antinociceptive and antiinflammatory activities, thus supporting previous claims regarding its traditional use by the Malays to treat various ailments, particularly those related to pain.
    Matched MeSH terms: Pain/chemically induced; Pain/prevention & control; Pain Measurement
  6. Fulltext Outpatient pre-operative assessment in joint replacement surgery
    Chan CY, Nam HY, Raveenthiran R, Choon SK, Tai CC
    Med J Malaysia, 2008 Jun;63(2):100-3.
    PMID: 18942292 MyJurnal
    An anaesthetist-led outpatient pre-operative assessment (OPA) clinic was introduced in our unit in an effort to improve patient care and cost-effectiveness. To assess the efficiency of the clinic, 112 patients who attended the OPA clinic (attendance rate 98%) during the first year were assessed prospectively and compared with 118 patients who did not undergo OPA the year before. There were fewer cancellations among those who attended the OPA clinic (13.6% compared to 3.6%), and the hospital stay was shortened from an average of 10.7 days to 7.0 days. This has resulted in more efficient utilization of operating theatre, reduced hospital costs and improved patient satisfaction. More extensive use of the pre-admission clinic is recommended and should be explored in other clinical settings.
    Study site: Outpatient Preoperative Assessment (OPA) clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Pain Measurement
  7. Fulltext Analgesic activity, toxicity study and phytochemical screening of standardized Cinnomomum iners leaves methanolic extract
    Mustaffa F, Indurkar J, Ismail S, Mordi MN, Ramanathan S, Mansor SM
    Pharmacognosy Res, 2010 Mar;2(2):76-81.
    PMID: 21808545 DOI: 10.4103/0974-8490.62952
    Cinnomomum iners standardized leaves methanolic extract (CSLE) was subjected to analgesic, toxicity and phytochemical studies. The analgesic activity of CSLE was evaluated using formalin, hot plate and tail flick tests at doses of 100, 200 and 500 mg/kg. CSLE showed significant activity (P < 0.05) in the formalin model (late phase) on the rats at doses of 200 and 500 mg/kg. However, CSLE did not show activity in the hot plate and tail flick tests. The results obtained suggest that CSLE acts peripherally to relieve pain. For the toxicity study, CSLE was orally administered to the Swiss albino mice according to the Organization for Economic Co-Operation and Development (OECD) guideline 423. There was no lethality or toxic symptoms observed for all the tested doses throughout the 14-day period. Phytochemical screening of CSLE showed the presence of cardiac glycoside, flavonoid, polyphenol, saponin, sugar, tannin and terpenoid.
    Matched MeSH terms: Pain
  8. Fulltext Calcification of the Alar Ligament Mimics Fracture of the Craniovertebral Junction (CVJ): An Incidental Finding from Computerised Tomography of the Cervical Spine Following Trauma
    Che Mohamed SK, Abd Aziz A
    Malays J Med Sci, 2009 Oct;16(4):69-72.
    PMID: 22135515 MyJurnal
    When performing a radiological assessment for a trauma case with associated head injury, a fragment of dense tissue detected near the craniovertebral junction would rapidly be assessed as a fractured bone fragment. However, if further imaging and evaluation of the cervical spine with computerised tomography (CT) did not demonstrate an obvious fracture, then the possibility of ligament calcification would be considered. We present a case involving a previously healthy 44-yearold man who was admitted following a severe head injury from a road traffic accident. CT scans of the head showed multiple intracranial haemorrhages, while scans of the cervical spine revealed a small, well-defined, ovoid calcification in the right alar ligament. This was initially thought to be a fracture fragment. Although such calcification is uncommon, accident and emergency physicians and radiologists may find this useful as a differential diagnosis in patients presenting with neck pain or traumatic head injury.
    Matched MeSH terms: Neck Pain
  9. Fulltext Dental infection presenting with ipsilateral parapharyngeal abscess and contralateral orbital cellulitis - a case report
    Embong Z, Ismail S, Thanaraj A, Hussein A
    Malays J Med Sci, 2007 Jul;14(2):62-6.
    PMID: 22993494 MyJurnal
    A 43 year-old man presented with pain on the right tooth for three days duration. Computed tomography showed left orbital cellulitis and right parapharyngeal abscess. There was also evidence suggestive of a dental abscess over right upper alveolar region. Magnetic resonance imaging revealed left superior ophthalmic vein thrombosis. Emergency drainage of the right parapharyngeal abscess was performed. Right maxillary molar extraction revealed periapical abscess. Left eye proptosis markedly reduced after initiating heparin.
    Matched MeSH terms: Pain
  10. Fulltext A case of trauma related Acanthamoeba keratitis
    Kamel AG, Faridah H, Yusof S, Norazah A, Nakisah MA
    Trop Biomed, 2004 Dec;21(2):135-8.
    PMID: 16493405 MyJurnal
    Acanthamoeba is an uncommon cause of keratitis but one of the most severe because of the prolonged and painful course of the disease and poor visual outcome. Although contact lens use is the principal risk factor, about 10% of cases occur following trauma and exposure to contaminated soil or water. Two cases of Acanthamoeba keratitis involving women contact lens wearers have previously been reported in Malaysia but this is the first time, a non contact lens related Acanthamoeba keratitis is reported. The case involved a 28 year old Indonesian male construction worker who had a trauma of the right eye during work. His eye was struck by sand and dust particles after which he quickly washed with water from an open tank at the construction site. He experienced pain, redness, glaring and blurring of vision of the right eye three days later. The diagnosis was missed at initial presentation but culture of the corneal scraping had proven Acanthamoeba as the aetiological agent. The history and clinical findings of this trauma related Acanthamoeba keratitis are briefly discussed.
    Matched MeSH terms: Pain
  11. Efficacy and safety of dexmedetomidine versus morphine in post-operative cardiac surgery patients
    Abd Aziz N, Chue MC, Yong CY, Hassan Y, Awaisu A, Hassan J, et al.
    Int J Clin Pharm, 2011 Apr;33(2):150-4.
    PMID: 21744187 DOI: 10.1007/s11096-011-9480-7
    OBJECTIVE: To compare the efficacy of dexmedetomidine versus morphine as a sedative/analgesic among post-operative cardiac surgery patients.

    METHOD: A randomized controlled open-label study was performed at the cardiothoracic intensive care unit of Penang Hospital, Malaysia. A total of 28 patients who underwent cardiac surgeries were randomly assigned to receive either dexmedetomidine or morphine. Both groups were similar in terms of preoperative baseline characteristics. Efficacy measures included sedation scores and pain intensity and requirements for additional sedative/analgesic. Mean heart rate and arterial blood pressure were used as safety measures. Other measures were additional inotropes, extubation time and other concurrent medications.

    RESULTS: The mean dose of dexmedetomidine infused was 0.12 [SD 0.03] μg kg⁻¹ h⁻¹, while that of morphine was 13.2 [SD 5.84] μg kg⁻¹ h⁻¹. Dexmedetomidine group showed more benefits in sedation and pain levels, additional sedative/analgesic requirements, and extubation time. No significant differences between the two groups for the outcome measures, except heart rate, which was significantly lower in the dexmedetomidine group.

    CONCLUSION: This preliminary study suggests that dexmedetomidine was at least comparable to morphine in terms of efficacy and safety among cardiac surgery patients. Further studies with larger samples are recommended in order to determine the significant effects of the outcome measures.

    Matched MeSH terms: Pain Measurement; Pain, Postoperative/etiology; Pain, Postoperative/prevention & control*
  12. Antinociceptive and anti-inflammatory activities of the aqueous extract of Kaempferia galanga leaves in animal models
    Sulaiman MR, Zakaria ZA, Daud IA, Ng FN, Ng YC, Hidayat MT
    J Nat Med, 2008 Apr;62(2):221-7.
    PMID: 18404328 DOI: 10.1007/s11418-007-0210-3
    This study was performed to determine the antinociceptive and anti-inflammatory activities of aqueous extract of Kaempferia galanga leaves using various animal models. The extract, in the doses of 30, 100, and 300 mg/kg, was prepared by soaking (1:10; w/v) the air-dried powdered leaves (40 g) in distilled water (dH(2)O) for 72 h and administered subcutaneously in mice/rats 30 min prior to the tests. The extract exhibited significant (P < 0.05) antinociceptive activity when assessed using the abdominal constriction, hot-plate and formalin tests, with activity observed in all tests occurring in a dose-dependent manner. Furthermore, the antinociceptive activity of K. galanga extract was significantly (P < 0.05) reversed when prechallenged with 10 mg/kg naloxone. The extract also produced a significantly (P < 0.05) dose-dependent anti-inflammatory activity when assessed using the carrageenan-induced paw-edema test. In conclusion, this study demonstrated that K. galanga leaves possessed antinociceptive and anti-inflammatory activities and thus supports the Malay's traditional uses of the plant for treatments of mouth ulcer, headache, sore throat, etc.
    Matched MeSH terms: Pain/chemically induced; Pain/drug therapy; Pain Measurement
  13. Challenges of having a child with thalassemia in Pakistan: A phenomenological study
    Rehman IU, Khan TM, Bukhsh A, Munawar K, Suleiman AK, Ming LC, et al.
    J Pediatr Nurs, 2023;72:e179-e186.
    PMID: 37414623 DOI: 10.1016/j.pedn.2023.06.026
    BACKGROUND: Thalassemia is a persistent hemolytic disease and has debilitating effects on patients and their parents. Parents of these children experience pain and suffer from additional emotional strain as they provide daily and lifetime care and are mostly concerned about the health and future of their children.

    AIM: The study aimed to understand the experiences of parents of children with thalassemia related to their family, financial, social, treatment, and psychological issues in Pakistan.

    METHODS: This descriptive phenomenological study recruited 21 parents of children with thalassemia through purposive sampling until data saturation was achieved. Analysis of transcribed interviews was performed through Colaizzi's method and themes and subthemes revolving around diagnosis, challenges, and treatment issues were extracted.

    FINDINGS: A total of 21 Pakistani parents participated in this study. Most of the participants were females (n = 16, 76.19%), housewives/stay-at-home moms (n = 13 (61.90%), and were uneducated (n = 6, 28.57%). Regarding genetic traits, only three (14.28%) parents declared that they had genetic traits of thalassemia. The findings of our study revealed that thalassemia is enormously influenced by psychosocial and economic problems because of this disease in their families.

    CONCLUSION: Our findings indicated that parents of these children face multi-faceted challenges, such as physical, socio-emotional, financial, and familial. These findings may lead to an adequate understanding of their individual needs and efficient utilization of supportive and care programs.

    PRACTICE IMPLICATIONS: An understanding of such experiences, involving those distinctive to Pakistani culture, is especially vital to inform the care of these children and enhance their quality of life.

    Matched MeSH terms: Pain
  14. Bullous cellulitis as an extraordinary manifestation of a Vibrio cholerae O1 Ogawa infection
    Ummu SF, Ding CH, Wahab AA, Tzar MN
    Trop Biomed, 2023 Jun 01;40(2):170-173.
    PMID: 37650403 DOI: 10.47665/tb.40.2.007
    Vibrio cholerae is a gram-negative bacterium synonymous with its namesake disease, cholera. Thus, gastrointestinal symptoms are the norm and V. cholerae is very rarely associated with skin and soft tissue infections. We describe a case of a 63-year-old Chinese woman with multiple medical comorbidities on corticosteroid therapy who developed fever and a painful swelling on her left leg after being pricked by a branch while gardening. There was no abdominal pain, vomiting or diarrhea. A diagnosis of bullous cellulitis was made clinically, and blood was sent for bacteriological culture. A beta-hemolytic commashaped gram-negative bacillus was isolated from the blood. It was also oxidase-positive and produced an acid/alkaline (A/K) reaction on triple sugar iron agar. It was identified biochemically as Vibrio cholerae. After additional testing, it was found to be of the O1 serogroup and Ogawa serotype. The infection resolved following a 10-day course of high-dose co-trimoxazole therapy.
    Matched MeSH terms: Abdominal Pain
  15. Spontaneous rupture of renal angiomyolipoma in pregnancy mimicking preterm labour
    Basri NI, Dasrilsyah RA
    BMJ Case Rep, 2024 Feb 06;17(2).
    PMID: 38320830 DOI: 10.1136/bcr-2023-258979
    Ruptured renal angiomyolipoma in pregnancy is uncommon. Pregnant women may present with nonspecific symptoms such as flank or abdominal pain, contraction pain and haematuria. A thorough assessment is needed to reach the correct diagnosis. Management varies between conservative measures, radiological intervention or surgery depending on the patient's haemodynamic status and foetal condition. We present a case of a woman in her 30s, gravida 5 para 3+1 at 28 weeks of gestation, who presented with pain. The pain worsened, and she went into hypovolaemic shock. An exploratory laparotomy and emergency caesarean section were done. Retroperitoneal haematoma was found intraoperatively, but the source of bleeding was difficult to determine. An abdominal CT angiogram subsequently revealed an ongoing bleeding from a ruptured angiomyolipoma. An emergency nephrectomy was performed, and the bleeding was secured.
    Matched MeSH terms: Pain
  16. Fulltext Coblation tonsillectomy versus dissection tonsillectomy: a comparison of intraoperative time, intraoperative blood loss and post-operative pain
    Izny Hafiz Z, Rosdan S, Mohd Khairi MD
    Med J Malaysia, 2014 Apr;69(2):74-8.
    PMID: 25241816 MyJurnal
    The objective of this study was to compare the intraoperative time, intraoperative blood loss and post operative pain between coblation tonsillectomy and cold tonsillectomy in the same patient. A prospective single blind control trial was carried out on 34 patients whom underwent tonsillectomy. The patients with known bleeding disorder, history of unilateral peritonsillar abscess and unilateral tonsillar hypertrophy were excluded. Operations were done by a single surgeon using cold dissection tonsillectomy in one side while coblation tonsillectomy in the other. Intraoperative time, intraoperative blood loss and post operative pain during the first 3 days were compared between the two methods. Results showed that the intraoperative time was significantly shorter (p<0.001) and intraoperative blood loss was significantly lesser (p<0.001) in coblation tonsillectomy as compared to cold tonsillectomy. Post operative pain score was significantly less at 6 hours post operation (p<0.001) in coblation tonsillectomy as compared to cold tonsillectomy. However, there were no differences in the post operative pain scores on day 1, 2 and 3. In conclusion, coblation tonsillectomy does have superiority in improving intraoperative efficiency in term of intraoperative time and bleeding compared to cold dissection tonsillectomy. The patient will benefit with minimal post operative pain in the immediate post surgery duration.
    Matched MeSH terms: Pain, Postoperative
  17. Fulltext The Effect of Channa striatus (Haruan) Extract on Pain and Wound Healing of Post-Lower Segment Caesarean Section Women
    Ab Wahab SZ, Abdul Kadir A, Nik Hussain NH, Omar J, Yunus R, Baie S, et al.
    Evid Based Complement Alternat Med, 2015;2015:849647.
    PMID: 26101537 DOI: 10.1155/2015/849647
    Channa striatus has been consumed for decades as a remedy to promote wound healing by women during postpartum period. The objectives of this study were to compare postoperative pain, wound healing based on wound evaluation scale (WES), wound cosmetic appearance based on visual analogue scale (VAS) scores and patient satisfaction score (PSS), and safety profiles between C. striatus group and placebo group after six weeks of lower segment caesarean section (LSCS) delivery. A randomised, double-blind, placebo-controlled study was conducted. Subjects were randomised in a ratio of 1 : 1 into either the C. striatus group (500 mg daily) or placebo group (500 mg of maltodextrin daily). 76 subjects were successfully randomised, with 38 in the C. striatus group and 35 in the placebo group. There were no significant differences in postoperative pain (p = 0.814) and WES (p = 0.160) between the C. striatus and placebo groups. However, VAS and PSS in the C. striatus group were significantly better compared with the placebo group (p = 0.014 and p < 0.001, resp.). The safety profiles showed no significant differences between the groups. In conclusion, six-week supplementation of 500 mg of C. striatus extract showed marked differences in wound cosmetic appearance and patient's satisfaction and is safe for human consumption.
    Matched MeSH terms: Pain, Postoperative
  18. Fulltext The brain in pain
    Ahmad AH, Abdul Aziz CB
    Malays J Med Sci, 2014 Dec;21(Spec Issue):46-54.
    PMID: 25941463 MyJurnal
    Pain, while salient, is highly subjective. A sensation perceived as painful by one person may be perceived as uncomfortable, not painful or even pleasant to others. Within the same person, pain may also be modulated according to its threat value and the context in which it is presented. Imaging techniques, such as functional magnetic resonance imaging and positron emission tomography, have identified a distributed network in the brain, the pain-relevant brain regions, that encode the sensory-discriminative aspect of pain, as well as its cognitive and affective/emotional factors. Current knowledge also implicates the prefrontal cortex as the modulatory area for pain, with its subdivisions forming the cortico-cortical pathway, an alternative pain modulatory pathway distinct from the descending modulatory pathway of pain. These findings from neuroimaging in human subjects have paved the way for the molecular mechanisms of pain modulation to be explored in animal studies.
    Matched MeSH terms: Pain
  19. Fulltext Congenital mastoid cholesteatoma presenting as a mass obstructing external auditory canal
    Khairunnisak M, Mohd Khairi MD
    Med J Malaysia, 2014 Dec;69(6):277-8.
    PMID: 25934960 MyJurnal
    We describe the clinical presentation, investigation and management of an eventually fatal case of hypercalcemic crisis due to primary hyperparathyridism (PHPT). A 60 year-old lady with history of urolithiasis presented with worsening generalized bone pain, spinal scoliosis and a limp. Laboratory data showed hypercalcemia and raised alkaline phosphatase. Left hip x-ray revealed a subcapital femoral neck fracture. Intact parathyroid hormone was elevated, 187.6 pmol/L (1.6 - 6.9) and ultrasound showed an enlarged right parathyroid gland. Despite initial reduction of serum calcium with saline infusion and multiple doses of intravenous pamidronate, her calcium increased to 4.14 mmol/L a week following application of Buck's traction for persistent left hip pain. She succumbed eventually with serum calcium peaking at 6.28 mmol/L despite multiple therapeutic interventions.
    Matched MeSH terms: Pain
  20. Fulltext Iatrogenic submandibular duct rupture complicating sialography: a case report
    Sharouny H, Omar RB
    Iran Red Crescent Med J, 2014 Sep;16(9):e7882.
    PMID: 25593739 DOI: 10.5812/ircmj.7882
    INTRODUCTION: Sialolithiasis is the most common disease of salivary glands. Sialography is particularly important for the assessment of the outflow tract and in diagnosing obstructive salivary gland lesions including calculi.

    CASE PRESENTATION: We report on a 38-year-old female with sialolithiasis whom had Wharton's duct perforation, complicating the sialography. She was treated conservatively with a course of co-amoxiclav, oral prednisolone for three days and pain-killers. The patient was clinically well on follow-up reassessments at the end of the first week and three weeks post procedure.

    CONCLUSIONS: Perforation of salivary duct complicating the sialography is rare. Awareness of this potential complication and utilizing a good sialography technique need to be advocated amongst radiologists. Response to treatment by conservative management is preferred as illustrated in this case.

    Matched MeSH terms: Pain
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