MyMedR

Fulltext Multiple coronary artery bypass grafting in dextrocardia: case report

Wong PS, Chong CL

Med J Malaysia, 1999 Dec;54(4):514-6.

This is a case report of an unusual case of a patient with dextrocardia and "situs inversus totalis" who presented with unstable angina. Coronary angiography revealed severe main stem and severe triple vessel coronary artery disease. The patient later underwent successful emergency coronary artery bypass graft surgery. To the authors' knowledge this is the first reported case in Malaysia and also, the first ever report in the literature of multiple vessel coronary artery grafting, including the use of the right internal mammary artery.

Matched MeSH terms: Angina, Unstable/complications; Dextrocardia/complications; Situs Inversus/complications

Acute myelomonocytic leukaemia complicated by an acute aortic thrombosis

Leong KW, Bosco JJ, Shaik IB

Postgrad Med J, 1995 Feb;71(832):112-3.

PMID: 7724422

Acute aortic thrombosis is a rare condition, occurring mainly as a result of trauma or atherosclerosis and occasionally secondary to hypercoagulable states. We report a patient with relapsed acute myeloid leukaemia who developed an unusual complication, acute aortic thrombosis.

Matched MeSH terms: Aortic Diseases/complications*; Thrombosis/complications*; Leukemia, Myelomonocytic, Acute/complications*

Burns in pregnancy--maternal and fetal prognosis

Cheah SH, Sivanesaratnam V

Aust N Z J Obstet Gynaecol, 1989 May;29(2):143-5.

PMID: 2803125

In this series the incidence of pregnancy in women in the reproductive age group admitted to hospital with burns was 7.8% (9 of 116). The maternal and perinatal outcome is related to the extent, presence or absence of complications of burns and to the gestational age of the fetus. Two maternal deaths in this series occurred in patients with burns involving more than 85% of the skin surface; in both instances stillbirths occurred less than 48 hours after the burns. In view of the high perinatal mortality, patients with extensive burns who are more than 32 weeks' pregnant should be delivered soon after admission. The extensively burned anterior abdominal wall can make assessment of uterine size difficult. An assessment in such a situation would be useful.

Matched MeSH terms: Burns/complications*; Pregnancy Complications*

Fulltext Haemangioma-thrombocytopenia syndrome--a case report

Liam CK, Nuruddin R

Med J Malaysia, 1989 Sep;44(3):263-6.

PMID: 2626143

A 29 year old Chinese female who presented with spontaneous purpura, was found to have gross hepatomegaly and thrombocytopenia. The thrombocytopenia responded to steroid therapy but relapsed when the dose of steroid was tapered down. Subsequent investigations revealed that the hepatomegaly was due to a large haemangioma of her liver. For symptomatic hepatic haemangioma, surgical excision is the treatment of choice; this was refused by the patient.

Matched MeSH terms: Hemangioma/complications*; Liver Neoplasms/complications*; Purpura, Thrombocytopenic/complications*

Fulltext Behcet's syndrome with sagittal sinus and inferior vena caval thrombophlebitis

Segasothy M

Med J Malaysia, 1982 Jun;37(2):132-3.

PMID: 7132832

This report describes a case of Behcet's syndrome in which there was involvement of both the intracranial and systemic veins. The pathogenesis of Behcet's syndrome is discussed.

Matched MeSH terms: Behcet Syndrome/complications*; Sinus Thrombosis, Intracranial/complications*; Thrombophlebitis/complications*

Acute septicemic melioidosis occurring in a child with acute lymphoblastic leukemia

Lin HP, Puthucheary SD, Sinniah D

Clin Pediatr (Phila), 1980 Oct;19(10):697-9.

PMID: 6931670

A 13-year old boy with acute lymphoblastic leukemia on chemotherapy developed neutropenia and acute cellulitis progressing to fulminating septicemia due to Pseudomonas pseudomallei. Septicemic melioidosis should be considered in the differential diagnosis of a febrile illness in children who are susceptible to infections.

Matched MeSH terms: Leukemia, Lymphoid/complications*; Melioidosis/complications*; Sepsis/complications*

Fulltext Bilateral optic neuritis in pregnancy

Suraiya MS, Norazlina B, Carmen C, Muhaya M

Med J Malaysia, 2003 Dec;58(5):771-3.

PMID: 15190668

A 25-year old primigravida at 11-weeks period of amenorrhoea presented with bilateral optic neuritis following Varicella Zoster viral (VZV) infection. She was serologically positive for systemic lupus erythematosus but negative for virus. The exact pathogenesis of the patient's severe optic neuritis, adduction and neurological deficit was unknown. The initiation of high dose steroids for optic neuritis was a big clinical dilemma in a pregnant patient with viral infection. The patient was treated with high dose steroids after three days of commencement of antiviral treatment. At 6 months after presentation, her visual acuity in the right eye was 6/36 with perception to light in the left.

Matched MeSH terms: Lupus Erythematosus, Systemic/complications; Pregnancy Complications, Infectious/virology*

Choriocarcinoma--an unusual case

Khoo KE

Med J Malaysia, 1978 Dec;33(2):156-7.

PMID: 755169

Matched MeSH terms: Choriocarcinoma/complications*; Hydatidiform Mole/complications*; Uterine Neoplasms/complications*

Post-dengue encephalopathy and Parkinsonism

Fong CY, Hlaing CS, Tay CG, Ong LC

Pediatr Infect Dis J, 2014 Oct;33(10):1092-4.

PMID: 24776518 DOI: 10.1097/INF.0000000000000382

Parkinsonism as a neurologic manifestation of dengue infection is rare with only 1 reported case in an adult patient. We report a case of a 6-year-old child with self-limiting post-dengue encephalopathy and Parkinsonism. This is the first reported pediatric case of post-dengue Parkinsonism and expands the neurologic manifestations associated with dengue infection in children. Clinicians should consider the possibility of post-dengue Parkinsonism in children with a history of pyrexia from endemic areas of dengue.

Matched MeSH terms: Brain Diseases/complications; Dengue/complications*; Parkinsonian Disorders/complications

Fulltext Relationship between hepatitis C virus infection and type 2 diabetes mellitus: meta-analysis

Naing C, Mak JW, Ahmed SI, Maung M

World J Gastroenterol, 2012 Apr 14;18(14):1642-51.

PMID: 22529694 DOI: 10.3748/wjg.v18.i14.1642

AIM: To investigate the association between hepatitis C infection and type 2 diabetes mellitus.
METHODS: Observational studies assessing the relationship between hepatitis C infection and type 2 diabetes mellitus were identified via electronic and hand searches. Studies published between 1988 to March 2011 were screened, according to the inclusion criteria set for the present analysis. Authors performed separate analyses for the comparisons between hepatitis C virus (HCV) infected and not infected, and HCV infected and hepatitis B virus infected. The included studies were further subgrouped according to the study design. Heterogenity was assessed using I(2) statistics. The summary odds ratios with their corresponding 95% CIs were calculated based on a random-effects model. The included studies were subgrouped according to the study design. To assess any factor that could potentially affect the outcome, results were further stratified by age group (proportion of ≥ 40 years), gender (proportion of male gender), body mass index (BMI) (proportion of BMI ≥ 27), and family history of diabetes (i.e., self reported). For stability of results, a sensitivity analysis was conducted including only prospective studies.
RESULTS: Combining the electronic database and hand searches, a total of 35 observational studies (in 31 articles) were identified for the final analysis. Based on random-effects model, 17 studies (n = 286,084) compared hepatitis C-infected patients with those who were uninfected [summary odds ratio (OR): 1.68, 95% CI: 1.15-2.45]. Of these 17 studies, 7 were both a cross-sectional design (41.2%) and cohort design (41.2%), while 3 were case-control studies (17.6%). Nineteen studies (n = 51,156) compared hepatitis C-infected participants with hepatitis B-infected (summary OR: 1.92, 95% CI: 1.41-2.62). Of these 19 studies, 4 (21.1%), 6 (31.6%) and 9 (47.4%) were cross-sectional, cohort and case-control studies, respectively. A sensitivity analysis with 3 prospective studies indicated that hepatitis C-infected patients had a higher risk of developing type 2 diabetes compared with uninfected controls (summary odds ratio: 1.41, 95% CI: 1.17-1.7; I(2) = 0%). Among hepatitis C-infected patients, male patients (OR: 1.26, 95% CI: 1.03-1.54) with age over 40 years (summary OR: 7.39, 95% CI: 3.82-9.38) had an increased frequency of type 2 diabetes. Some caution must be taken in the interpretation of these results because there may be unmeasured confounding factors which may introduce bias.
CONCLUSION: The findings support the association between hepatitis C infection and type 2 diabetes mellitus. The direction of association remains to be determined, however. Prospective studies with adequate sample sizes are recommended.

Matched MeSH terms: Diabetes Mellitus, Type 2/complications*; Hepatitis B/complications; Hepatitis C/complications*

Maternal obesity and pregnancy outcome

Begum KS, Sachchithanantham K, De Somsubhra S

Clin Exp Obstet Gynecol, 2011;38(1):14-20.

PMID: 21485717

The increasing prevalence of maternal obesity worldwide provides a major challenge to obstetric practice from preconception to postpartum. Maternal obesity can result in unfavorable outcomes for the woman and fetus. Maternal risks during pregnancy include gestational diabetes and chronic hypertension leading to preeclampsia. The fetus is at risk for stillbirth and congenital anomalies. Intrapartum care, normal and operative deliveries, anesthetic and operative interventions in the obese demand extra care. Obesity in pregnancy can also affect health later in life for both mother and child. For women, these risks include heart disease and hypertension. Children have a risk of future obesity and heart disease. Women and their offspring are at increased risk for diabetes. Obstetrician-gynecologists should be well informed to prevent and treat this epidemic. Interventions directed at weight loss and prevention of excessive weight gain during pregnancy must begin in the preconception period.

Matched MeSH terms: Obesity/complications*; Pregnancy Complications/etiology*

Predictors of acute neurological complication following tetralogy of Fallot operation in Serdang Hospital, Malaysia

Yap MT, Yubbu P, Yong SW, Hing WV, Ong YS, Devaraj NK, et al.

Med J Malaysia, 2020 09;75(5):494-501.

PMID: 32918416

BACKGROUND: The long waiting time for Tetralogy of Fallot (TOF) operation may potentially increase the risk of hypoxic insult. Therefore, the objective of this study is to determine the frequency of acute neurological complications following primary TOF repair and to identify the peri-operative risk factors and predictors for the neurological sequelae.

METHODS: A retrospective review of the medical and surgical notes of 68 patients who underwent TOF repair in Hospital Serdang, from January 2013 to December 2017 was done. Univariate and multivariate analyses of demographics and perioperative clinical data were performed to determine the risk for the development of acute neurological complications (ANC) among these patients.

RESULTS: ANC was reported in 13 cases (19.1%) with delirium being the most common manifestation (10/68, 14.7%), followed by seizures in 4 (5.9%) and abnormal movements in two patients (2.9%). Univariate analyses showed that the presence of right ventricular (RV) dysfunction, prolonged duration of inotropic support (≥7 days), prolonged duration of mechanical ventilation (≥7 days), longer length of ICU stays (≥7 days), and longer length of hospital stay (≥14 days), were significantly associated with the presence of ANCs (p<0.05). However, multivariate analyses did not show any significant association between these variables and the development of ANC (p>0.05). The predictors for the development of postoperative delirium were pre-operative oxygen saturation less than 75% (Odds Ratio, OR=16.90, 95% Confidence Interval, 95%CI:1.36, 209.71) and duration of ventilation of more than 7 days (OR=13.20, 95%CI: 1.20, 144.98).

CONCLUSION: ANC following TOF repair were significantly higher in patients with RV dysfunction, in those who required a longer duration of inotropic support, mechanical ventilation, ICU and hospital stay. Low pre-operative oxygen saturation and prolonged mechanical ventilation requirement were predictors for delirium which was the commonest neurological complications observed in this study. Hence, routine screening for delirium using an objective assessment tool should be performed on these high-risk patients to enable accurate diagnosis and early intervention to improve the overall outcome of TOF surgery in this country.

Matched MeSH terms: Postoperative Complications*; Tetralogy of Fallot/complications*

Pregnancy and Dumping Syndrome post-bariatric surgery: a case report

Edawati DE, Abigail J, Mardiana K, Ming-Cheng C, Harris NS

Med J Malaysia, 2017 04;72(2):133-134.

PMID: 28473681 MyJurnal

This case report discusses dumping syndrome in the postbariatric mother. Diagnostically a challenge, the symptoms of postprandial hypoglycaemia mimic common early gestation complaints and may go undiagnosed, thus requiring a high index of suspicion. As weight-loss surgery gains traction, it is pertinent to note at booking and followups. The pregnancy is at-risk and multidisciplinary team management is central. The mainstay of management remains diet modification. There have been case reports of successful medical treatment of dumping syndrome in pregnancy with good maternal and fetal outcomes. However, more data is needed regarding the usage of these medical treatments in pregnancy.

Matched MeSH terms: Dumping Syndrome/complications*; Pregnancy Complications/etiology*

Maternal mortality in the government hospitals, West Malaysia 1967-1969

Ariffin Bin Marzuki, Thambu JA

Med J Malaysia, 1973 Mar;27(3):203-6.

PMID: 4268925

Matched MeSH terms: Pregnancy Complications, Hematologic/mortality; Pregnancy Complications, Infectious/mortality

Idiopathic Addison's disease

Ang GS, Da Costa JL

Med J Malaya, 1971 Dec;26(2):137-8.

PMID: 4260861

Matched MeSH terms: Addison Disease/complications*; Amenorrhea/complications*; Autoimmune Diseases/complications

Sarcocystis infection in an Orang Asli: the second human case from Malaysia

Kutty MK, Mohan Das A, Dissanaike AS

Southeast Asian J. Trop. Med. Public Health, 1975 Sep;6(3):400-1.

PMID: 816009

The second case of Sarcocystis infection in man is reported from an aborigine girl. It was an incidental finding at autopsy and two cysts were seen in the muscle of the oropharyngeal region. The cysts and zoites were similar to those in the previous case reported from Malaysia.

Matched MeSH terms: Brain Neoplasms/complications; Melanoma/complications; Sarcocystosis/complications

Fulltext The crucial role of molecular testing to facilitate the diagnosis of pneumocystis pneumonia during pregnancy

Ding CH, Yusoff H, Muttaqillah NAS, Tang YL, Tan TL, Periyasamy P, et al.

Malays J Pathol, 2018 Apr;40(1):69-72.

PMID: 29704387 MyJurnal

Pneumocystis pneumonia is an important human immunodeficiency virus (HIV)-associated opportunistic infection, and especially so in pregnant HIV-positive patients. We report a case of a 40-year-old woman in her first trimester of pregnancy who initially presented with acute gastroenteritis symptoms but due to a history of high-risk behaviour and the observation of oral thrush, she was worked up for HIV infection. Her retroviral status was positive and her CD4+ T cell count was only 8 cells/µL. She was also worked up for pneumocystis pneumonia due to the presence of mild resting tachypnoea and a notable drop in oxygen saturation (from 100% to 88%) following brief ambulation. Her chest radiograph revealed bilaterally symmetrical lower zone reticular opacities and Giemsa staining of her bronchoalveolar lavage (BAL) was negative for Pneumocystis jirovecii cysts. However, real-time P. jirovecii polymerase chain reaction (PCR) testing on the same BAL specimen revealed the presence of the organism. A course of oral co-trimoxazole plus prednisolone was commenced and her clinical condition improved.

Matched MeSH terms: Pregnancy Complications, Infectious/immunology*; HIV Infections/complications*

Fulltext Rare post-operative complications in a previously undiagnosed Congenital Factor X deficiency patient

Mohd Nazri H, Suhair AA, Wan Suriana WA, Zefarina Z, Azlan H, Wan Zaidah A

Malays J Pathol, 2016 Dec;38(3):327-331.

PMID: 28028305 MyJurnal

Factor X (FX) deficiency is a rare autosomal recessive congenital bleeding disorder. The clinical presentation is among the most severe among the rare coagulation defects. Thus, majority of diagnosed patients will receive factor replacement therapy before surgical manipulation. However, the diagnosis of FX deficiency may be overlooked because it is a rare entity. This is a case report of a 15-year-old male patient who was diagnosed with FX deficiency after developing post-operative complications. With regular fresh frozen plasma infusion given, the patient responded well and recovered. However, had he been diagnosed earlier pre-operatively, the post-operative complication could have been prevented. Therefore, pre-operative coagulation screening should be performed in patients with significant bleeding history in both emergency and elective situations to prevent surgical morbidity related to post-operative bleeding.

Matched MeSH terms: Factor X Deficiency/complications*; Postoperative Complications/blood*

Fulltext Opsoclonus

Amin OS, Shwani SS

BMJ Case Rep, 2017 Feb 15;2017.

PMID: 28202488 DOI: 10.1136/bcr-2017-219433

Matched MeSH terms: Myoclonus/complications*; Ocular Motility Disorders/complications*; Gait Ataxia/complications*

Fulltext Pregnancy outcomes in women with non-transfusion dependent thalassaemia (NTDT): A haematology centre experience

Lee BS, Sathar J, Sivapatham L, Lee LI

Malays J Pathol, 2018 Aug;40(2):149-152.

PMID: 30173232 MyJurnal

INTRODUCTION: Non-transfusion dependent thalassaemia (NTDT) is a term used for thalassaemia patients who do not require lifelong regular transfusions for survival. Pregnancy in these women, whether spontaneous or through assisted reproductive technology, represents a challenge for the physician.
MATERIALS AND METHODS: The maternal and foetal outcomes of patients with NTDT followed up in a tertiary haematology centre over 6 months period were studied. A total of 36 pregnancies in 26 pregnant women with NTDT were analysed.
RESULTS: Among these women, all of the pregnancies resulted in successful delivery of singleton live-born neonates. There were four clinically distinct forms of NTDT among these women which include Hb E/β-thalassemia (mild and moderate forms), HbH disease, HbH-Constant Spring, and homozygous δβ-thalassemia. No blood transfusion was needed in 15 of the 36 pregnancies (41.6%). The lowest mean Hb level in which no blood transfusion was given was 8.21 g/dL. The mean of packed-cell units received during pregnancy was 6.95 units per pregnancy. There was no worsening of serum ferritin observed during pregnancy with mean serum ferritin pre- and post-pregnancy of 409.35 ug/L and 418.18 ug/L respectively. The mean gestational age at delivery was 38.6 weeks with no preterm delivery reported. The mean foetal birth weight was 2729 grams. There was no intrauterine growth restriction (IUGR) or congenital malformation. There was a case of small for gestational age (SGA) and a case of oligohydramnios.
CONCLUSION: This study showed that pregnancy was possible, safe and has a favourable outcome in patients with NTDT with multidisciplinary care.

Matched MeSH terms: Pregnancy Complications, Hematologic*; Thalassemia/complications*

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