MyMedR

Fulltext The status of intermittent peritoneal dialysis in Hospital University Science Malaysia

Zainal D, Loo CS

Singapore Med J, 1995 Aug;36(4):379-82.

PMID: 8919150

Acute (stab) peritoneal dialysis is commonly practised in Malaysia. This study is designed to improve the management of peritoneal dialysis (PD) in Hospital University Science Malaysia (HUSM). Consecutive peritoneal dialysis (PD) on adult inpatients from May 1992 to September 1992 were reviewed prospectively. There were 40 episodes of peritoneal dialysis on 27 patients during this period given at the rate of 2 PD per week. The mean age of patients were 53 +/- 15 years. Uraemia was the main indication for dialysis, while hyperkalaemia and pulmonary oedema were indications for urgent dialysis. Complications occurred in 14 episodes of dialysis (35%). The most common complication was bleeding in the peritoneal cavity while peritonitis was the second most common complication. Dialysis episodes complicated by peritonitis were done by less experienced performers compared to uncomplicated dialysis episodes. Overall mean time spent on each dialysis and time per cycle were longer than recommended (59 +/- 24 hours and 77 +/- 14 minutes). In conclusion, acute PD performed on patients admitted in Hospital University Malaysia was safe and had complication rates comparable to other established centres. However, improvements are possible through closer supervision of new doctors and tighter nursing precautions.

Fulltext The spectrum of malignant neoplasms in Sarawak: January 1976--December 1977

Kothare SN

Singapore Med J, 1978 Jun;19(2):98-105.

PMID: 751194

This is an analysis of histologically proven neoplasms encountered in Sarawak in 1976 and 1977. There were 1447 benign and 1368 malignant tumours. The detailed breakdown of malignant neoplasms with their racial and sex distribution is reported, Lymph node involvement, with primary and metastatic lesions, constituted the largest single group with 22.3 per cent of all malignancies. The next in order of frequency was the Reproductive system with a marked preponderance of Cervical Carcinoma in females. The next in frequency were Skin cancers (8.85%) and Nasopharyngeal Carcinoma (8.4%). Primary liver cell cancer and Breast cancer constituted 5.85 per cent and 5.79 per cent respectively of all malignant tumours. The high prevalence of malignant neoplasms in Chinese is suggestive of racial predisposition.

Fulltext The spectrum of beta-globin gene mutations in children with beta-thalassaemia major from Kota Kinabalu, Sabah, Malaysia

Thong MK, Soo TL

Singapore Med J, 2005 Jul;46(7):340-3.

PMID: 15968446

Beta-thalassaemia major is one of the commonest genetic disorders in South East Asia. The strategy for the community control of beta-thalassaemia major requires the characterisation of the spectrum of beta-globin gene mutations in any multi-ethnic population. There is only a single report of mutation analyses of the beta-globin gene in an isolated Kadazandusun community in Kota Belud, Sabah, Malaysia, which showed the presence of a common 45 kb deletion.

Fulltext The scope of blood genetic marker investigations in paternity testing in Chinese and Malays

Hawkins BR

Singapore Med J, 1974 Jun;15(2):128-31.

PMID: 4416484

The chance of excluding from paternity a falsely accused Chinese man and a falsely accused Malay man by using a number of blood genetic marker systems have been calculated using the ABO, Rhesus and MNSs systems, the combined chances are. 46.4% for a Chinese and 50.2% for a MaIay. When serum protein and red cell enzyme systems are included, the chances increase to approximately 76%. The chances may be increased by testing for haemoglobin variants, by red cell typing for the Diego (Di^a)
antigen, and by testing for phenotypes other than Gm(a) in the Gm system. The Kell system may in some circumstances provide evidence in favour of paternity.

Fulltext The role of endovaginal ultrasonography and the value of endometrial biopsy in breast cancer patients on tamoxifen therapy

Sivalingam N, Pathmalingam A

Singapore Med J, 1999 Jun;40(6):402-4.

PMID: 10489508

Endometrial changes have been observed when tamoxifen is used as an adjuvant therapy for carcinoma of the breast in postmenopausal women with positive estrogen receptors status.

Fulltext The role of computed tomography in the evaluation of retinoblastoma

Sherazi ZA, Jayakumar CR

Singapore Med J, 1992 Oct;33(5):496-9.

PMID: 1455277

To assess the importance of Computed Tomography(CT) in the evaluation of retinoblastoma, we reviewed thirteen cases of retinoblastoma which presented at Hospital University Sains Malaysia, Kelantan, Malaysia, from August 1986 to June 1991. High resolution computed tomography of the orbits was performed in all patients prior to therapy. Nine patients (69%) had unilateral and four (31%) had bilateral retinoblastoma. The interesting features were the remarkably high incidence in the right eye (89%) as compared to the left eye (11%) in unilateral retinoblastoma, and overall predominance of the male population (male to female ratio was 2:1). Computed tomography detected intraocular calcification in 82% of the tumourous eyes. All patients presented at late stages when tumours were of large size. The presence of calcification was not related to the size of the tumour. CT detected calcification in a suspected retinoblastoma with a high degree of accuracy. Computed tomographic evidence of intraocular calcification in children under 3 years of age is highly suggestive of retinoblastoma.

Fulltext The role of 99mtechnetium (Tc) diethyl-iminodiacetic acid (EHIDA) hepatobiliary scintigraphy in the diagnosis of a rare cause of obstructive jaundice

Lai FM, Paramsothy M, George J, Yip CH

Singapore Med J, 1996 Jun;37(3):261-3.

PMID: 8942223

This paper illustrates the role of 99m-Technetium(Tc) diethyl-iminodiacetic acid (EHIDA) hepatobiliary scintigraphy in a patient who developed obstructive jaundice as a result of afferent loop syndrome, which is a rare occurrence. The computed tomographic (CT) and ultrasonographic findings are also described.

Fulltext The rationale of treatment of maladaptation syndrome

Gwee AL

Singapore Med J, 1974 Jun;15(2):115-7.

PMID: 4416449

Fulltext The rapid urease test in the diagnosis of Helicobacter pylori infection

Goh KL, Parasakthi N, Peh SC, Puthucheary SD, Wong NW

Singapore Med J, 1994 Apr;35(2):161-2.

PMID: 7939811

With the increasing recognition of the importance of H. pylori in gastrointestinal disease, there is a need for a reliable, efficient and yet inexpensive diagnostic test. The performance of the rapid urease test (RUT) as an endoscopy suite diagnostic test was compared to the established methods of culture, histology and Gram stain of tissue smear, in 274 gastric biopsy samples. Histology had the highest sensitivity of 99.3% followed by the RUT (96.6%). Culture and Gram stain of tissue smear had 100% specificity, while the rapid urease test had 99.2% specificity. The RUT had a positive predictive value of 99.3% and a negative predictive value of 96.2%. The RUT is an inexpensive, rapid and reliable diagnostic test of H. pylori infection.

Fulltext The radiographic appearance of ameloblastoma in Malaysians

Yaacob H

Singapore Med J, 1991 Feb;32(1):70-2.

PMID: 2017711

The radiographs of fifteen Malaysian patients with presenting ameloblastoma aged between 20-55 years (average 35 years) were studied for any peculiar local features. The most common features were cortical plate expansion (80%), corticated scalloped margin (67%), multiloculation (87%), and resorption of tooth roots (47%). The latter two features are constantly found in advanced tumour stage. As pain was not a frequent complaint, many Malaysian patients seek treatment only at a very late stage after the tumours have reached large dimensions. Although ameloblastomas may be diagnosed often through radiographs, it should not be relied upon solely.

Fulltext The prognostic value of tissue factor levels in acute ischaemic stroke

Halim AG, Hamidon BB, Cheong SK, Raymond AA

Singapore Med J, 2006 May;47(5):400-3.

PMID: 16645690

There is no biological marker that can accurately predict the prognosis after an acute ischaemic stroke. The main objective of this study was to evaluate the prognostic value of tissue factor (thromboplastin) levels in first ischaemic stroke.

Fulltext The product of outcome-based undergraduate medical education: competencies and readiness for internship

Lai NM, Ramesh JC

Singapore Med J, 2006 Dec;47(12):1053-62.

PMID: 17139402

INTRODUCTION: Outcome-based curriculum is adopted at the International Medical University (IMU), Malaysia, where specific learning objectives are laid out progressively under eight major outcomes. We present an outcome-guided, self-reported competency profile of our undergraduate students near the end of their training, focusing on elements that are considered most immediately relevant for their internship.
METHODS: Anonymous surveys were conducted on two cohorts of medical students in their final semester at IMU. The surveys covered a range of competencies, including practical skills, ward routines, generic attributes and evidence-based medicine, grouped under the exit outcomes as defined by the university.
RESULTS: A total of 92 students were assessed. In general, the students were confident of their ability on common practical skills and ward routines. They were comfortable with the level of professionalism and personal attributes required for internship, with the prospect of handling unexpected additional tasks and working away from home perceived as the main difficulties. Most students referred to at least three sources of clinical information to answer their clinical queries. However, they referred more to single journals than databases or collections. The majority could critically appraise journal articles to a variable extent, but nearly half took 30 minutes or longer to trace an abstract of interest.
CONCLUSION: This report demonstrates the strength of outcome-based curriculum in its ability to produce competent students that are well prepared for their internship. Assessing students using this educational approach provides a clear picture of their strengths and weaknesses, and identifies stages in their training where additional inputs are required.

Fulltext The problem of uterine cervical carcinoma in Singapore and West Malaysia

Chan LKC

Singapore Med J, 1970 Sep;11(3):140-6.

PMID: 5472054

Fulltext The prevalence of obesity among clinical students in a Malaysian medical school

Boo NY, Chia GJ, Wong LC, Chew RM, Chong W, Loo RC

Singapore Med J, 2010 Feb;51(2):126-32.

PMID: 20358151

INTRODUCTION: This study aimed to determine the prevalence of obesity among medical students and its relationship with their dietary intake and physical activities.
METHODS:This observational study was carried out on 240 medical students during the clinical phase of their medical course in a private medical school. Their body weight and height were measured, and a standardised questionnaire was used to collect information on their physical activities and dietary intake.
RESULTS: The median body weight of the participants was 59.0 kg (interquartile range: 51.3-66.8), the mean body height was 166.1 cm (standard deviation [SD] 8.5 cm), and the mean body mass index (BMI) was 21.8 kg/m2 (SD 3.4 kg/m2). Based on the World Health Organization BMI cut-offs for the Asian population, 30.1 percent (n is equal to 72) of the students were overweight or obese, with a BMI that was equal to or greater than 23.0 kg/m2. Logistic regression analysis showed that, after controlling for various potential confounders, the only significant risk factors associated with overweight/obesity among these students were: male gender (adjusted odds ratio [OR] 2.1; 95 percent confidence intervals [CI] of 1.1 and 4.1; p is equal to 0.03), Malay ethnic group (adjusted OR 2.4; 95 percent CI 1.0 and 5.7; p is equal to 0.04), Indian ethnic group (adjusted OR 3.6; 95 percent CI 1.5 and 8.9; p is equal to 0.005), and the number of soft drinks consumed per week (adjusted OR 1.3; 95 percent CI 1.0 and 1.5; p is equal to 0.02). Skipping breakfast, the frequency of physical exercise per week, the number of hours of sleep per day, and eating noodles or roti canai (a type of Malaysian pancake) for breakfast were not significant risk factors.
CONCLUSION: Obesity remains a common problem among medical students in their clinical years.

Fulltext The predictors of early infection after an acute ischaemic stroke

Hamidon BB, Raymond AA, Norlinah MI, Jefferelli SB

Singapore Med J, 2003 Jul;44(7):344-6.

PMID: 14620725

Infection is a frequent complication after an acute stroke and may affect stroke outcome. We identified predictors of early infection, type of infection, their relation to initial disability, and the eventual outcome during the inpatient period.

Fulltext The predictive value of early molecular response in chronic myeloid leukaemia patients treated with imatinib in a single real-world medical centre in a developing country

Bee PC, Sekaran V, Ng RR, Kweh TY, Gan GG

Singapore Med J, 2017 Mar;58(3):150-154.

PMID: 27029807 DOI: 10.11622/smedj.2016063

INTRODUCTION: The prognosis of patients with chronic myeloid leukaemia (CML) has improved since the introduction of imatinib. However, patients who do not achieve complete cytogenetic response (CCyR) and major molecular response (MMR) have poorer prognosis. Recent clinical trials have demonstrated that early and deeper cytogenetic and molecular responses predict a better long-term outcome. This study aimed to analyse the relationship between early molecular response and clinical outcome in a real-life setting.

METHODS: This retrospective study included all patients with CML, in chronic or accelerated phase, who were treated with imatinib at University of Malaya Medical Centre, Malaysia.

RESULTS: A total of 70 patients were analysed. The median follow-up duration was 74 months, and the cumulative percentages of patients with CCyR and MMR were 80.0% and 65.7%, respectively. Overall survival (OS) and event-free survival (EFS) at ten years were 94.3% and 92.9%, respectively. Patients who achieved CCyR and MMR had significantly better OS and EFS than those who did not. At six months, patients who had a BCR-ABL level ≤ 10% had significantly better OS and EFS than those who had a BCR-ABL level > 10%. The target milestone of CCyR at 12 months and MMR at 18 months showed no survival advantage in our patients.

CONCLUSION: Our data showed that imatinib is still useful as first-line therapy. However, vigilant monitoring of patients who have a BCR-ABL level > 10% at six months of treatment should be implemented so that prompt action can be taken to provide the best outcome for these patients.

Fulltext The pattern of acute renal failure in Kelantan

Zainal D, Loo CS

Singapore Med J, 1996 Feb;37(1):44-7.

PMID: 8783912

Acute renal failure (ARF) has undergone many changes with advances both in diagnosis and therapy. A retrospective study covering three and a half years from June 1986 to December 1989 of adults admitted to Hospital of the University of Science Malaysia examined the various aspects of presentation of the syndrome, management and areas where improvement can be made. A total of 164 patients were included in the study. 61.6% were male and 38.4% were female. The mean age was 49.8 +/- 17.2 years with 70% of patients being more than 40 years old. The aetiologies of acute renal failure were analysed and discussed. The majority of the patients (80%) had non-oliguric acute renal failure. Oliguric acute renal failure patients have higher mortality and more frequently need dialysis. Early recognition of acute renal failure and discerning use of nephrotoxic drugs could result in decrease in incidence and severity of renal failure.

Fulltext The outcome of patients with acute bronchial asthma presenting to the emergency room

Yaacob I, Omar R, Mustafa WN

Singapore Med J, 1991 Jun;32(3):166-8.

PMID: 1876890

We collected data on patients above the age of 5 years with acute bronchial asthma who presented to the emergency room of Hospital Sains Universiti Sains Malaysia during the period between 1 January to 31 March 1990. Two hundred and twelve patients (57% males and 43% females) who made a total of 271 visits were recorded. This constitutes 16.3% of all adults and paediatric medical cases seen in the emergency room during this period. The majority of patients presented between 8 pm and 6 am which contrasts with the attendance pattern due to other causes. We also recorded two peak periods of presentation (between 8 pm and 12 midnight and between 6 am and 10 am). Thirty-one (11.4%) cases resulted in admission. Of the 240 cases that were successfully treated and discharged from the emergency room, there were 59 relapses (in 45 patients). Twenty-two percent of the relapses occurred within 24 hours of the last visits. We recorded lower rates of admission as well as relapses compared to all previous studies. Our finding of bimodal pattern of presentations was also not previously reported.
Study site: Emergency department, Hospital Sains Universiti Sains Malaysia, Kelantan, Malaysia

Fulltext The orthotic management of the congenitally short lower limb--a new appliance

Devnani AS

Singapore Med J, 2000 Nov;41(11):534-7.

PMID: 11284611

To describe an appliance used for equalisation of severe congenital lower limb length discrepancy for patients who refuse to undergo any operative correction but wish to walk and look better.

Fulltext The need for drug and poison information--the Singapore physicians' perspective

Ponampalam R, Anantharaman V

Singapore Med J, 2003 May;44(5):231-42.

PMID: 13677359

There appears to be a significant prevalence of poisoning and adverse drug reactions in Singapore. However, the resources needed by physicians to assist them in the management of such cases are limited. This study examines the information resources currently utilised by medical professionals in assisting them in the management of poisonings and adverse drug reactions. The preferred features of an ideal Drug and Poison Information Centre in the local setting were also explored.

Displaying publications 81 - 100 of 927 in total