Displaying publications 81 - 100 of 525 in total

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  1. Fulltext Concurrent Influenza A and Pulmonary Melioidosis in pregnancy
    Tan WF, Lee HG
    Med J Malaysia, 2021 03;76(2):245-247.
    PMID: 33742637
    Melioidosis is endemic in Sabah. It causes significant morbidity and mortality if diagnosis and treatment is delayed. Important risk factors include diabetes, chronic kidney diseases, chronic lung diseases, thalassaemia, immunosuppressive therapy, and hazardous alcohol consumption. Influenza A is usually a self-limiting disease but is associated with high morbidity and mortality in highrisk populations especially during pregnancy. Both melioidosis and influenza A commonly present in patients with pneumonia. Secondary bacterial pneumonia is a known complication in approximately one third of patients with severe pneumonia due to influenza A, resulting in intensive care unit admissions. However, melioidosis is not commonly recognized as an aetiology in secondary bacterial pneumonia complicating influenza A infection. This is important as empirical antibiotics that are used to treat secondary bacterial pneumonia due to influenza A often do not cover melioidosis. Here we report a rare case of concurrent pulmonary melioidosis and influenza A in a 30- year-old primigravida at 27 weeks of pregnancy in the Queen Elizabeth Hospital, Sabah, Malaysia to highlight the challenge in the recognition and management of both infections in a melioidosis endemic area.
    Matched MeSH terms: Hospitals, General
  2. Pediatric subperiosteal orbital abscess secondary to acute sinusitis: a 5-year review
    Tan VES
    Am J Otolaryngol, 2011 Jan-Feb;32(1):62-8.
    PMID: 20031268 DOI: 10.1016/j.amjoto.2009.10.002
    Objective: Subperiosteal orbital abscesses (SPOAs) secondary to acute sinusitis are rare occurrences in the pediatric age group, more so in the neonatal period. Here, a rare case of SPOA in a 38-day-old newborn later drained via endoscopic sinus surgery is included also. This review describes the demographic data, clinical history, treatment, microbiology results, complications, and outcome.
    Methods: The admission records for all the patients who were admitted to the Pediatric Surgical Ward in Sarawak General Hospital, Kuching, Malaysia, between January 2004 and May 2009 were retrospectively reviewed. Records of patients who presented with preseptal cellulitis, orbital cellulitis, subperiosteal abscess (extraconal), orbital abscess (intraconal), and cavernous sinus thrombosis were closely studied. Ophthalmology consultations were obtained in all these cases. Ultimately, 3 patients having SPOA secondary to acute sinusitis were selected for this review.
    Results: All patients were male with rapid onset of periorbital signs, absence of purulent rhinorrhea, and presence of significant thrombocytosis (exceeding 500 × 109/L). The 38-day-old newborn had mixed infection of methicillin-resistant coagulase-negative Staphylococcus bacteremia and local Acinetobacter eye infection with Staphylococcus aureus in the SPOA. All had medially located SPOA that was adequately drained via endoscopic sinus surgery, resulting in full recovery.
    Conclusion: Newborns with preexisting risk factors and immature immunity are at risk of severe and rare infections. Contrast-enhanced paranasal sinus computed tomographic scan is mandatory and reliable to differentiate preseptal and postseptal orbital infection, as both conditions can present similarly and rapidly deteriorate. In the contrast-enhanced computed tomography–demonstrable SPOA, endoscopic sinus surgery drainage of the abscess proved to be safe and reliable as the main treatment modality. All patients recovered well without complications.
    Matched MeSH terms: Hospitals, General
  3. Re-evaluation of malnutrition risk screening tool-hospital (MRST-H) for geriatric patients: a multicentre study in Peninsular Malaysia
    Tan SL, Sakinah Harith, Hasmah Abdullah, Wan Nazirah Wan Yusuf
    Sains Malaysiana, 2016;45:1311-1317.
    A local Malnutrition Risk Screening Tool-Hospital (MRST-H) has been developed to identify the risk of malnutrition among hospitalized geriatric patients in Malaysia. The aims of this multicenter study were to evaluate the criterion validity of the MRST-H against the reference standard Subjective Global Assessment (SGA) and revise its scoring criteria among Malaysian geriatric patients. A cross-sectional study was conducted among 542 geriatric patients at eight general hospitals in Peninsular Malaysia from January 2011 to February 2013. The Malay version MRST-H and SGA were administered to all participants through face-to-face interviews. Sensitivity and specificity of MRST-H were established using the Receiver Operating Characteristic (ROC) curves and the optimal cut-off scores were determined. The MRST-H had area under the ROC curve (AUC) values of 0.84 and 0.88 when validated against the SGA-determined malnutrition (SGA B+C) and severe malnutrition (SGA C) status. These high AUC values indicated that the MRST-H has very good overall diagnostic accuracy. However, the original cut-off score of five points for MRST-H has undesirable sensitivity in identifying the malnutrition (sensitivity = 0.12) and severely malnutrition (sensitivity = 0.35) status. The optimal cut-off score of MRST-H in identifying malnourished and severely malnourished participants were both established at the cut-off score of two points. The sensitivity of MRST-H increased substantially at this point without compromising its specificity. Therefore, the established cut-off score of two points with optimal sensitivity and specificity was selected to replace to original cut-off score for screening of risk of malnutrition among hospitalized geriatric patients.
    Matched MeSH terms: Hospitals, General
  4. Fulltext Retained intraocular foreign bodies and visual prognosis
    Tan PL
    Med J Malaysia, 1980 Sep;35(1):58-60.
    PMID: 7254000
    3 cases of perforating injury with retention of intra-ocular foreign body are presented. Their clinical presentation, management and final visual results are discussed. Despite the generally poor prognosis associated with these injuries, some cases surprisingly have good visual results.
    Matched MeSH terms: Hospitals, General
  5. Fulltext Preventing tuberculosis in healthcare workers of the radiology department: a Malaysian perspective
    Tan L, Kamarulzaman A
    Biomed Imaging Interv J, 2006 Jan;2(1):e3.
    PMID: 21614220 MyJurnal DOI: 10.2349/biij.2.1.e3
    Tuberculosis (TB) is a well recognised occupational hazard for healthcare workers (HCWs). Concerns on the safety of healthcare settings in Malaysia was raised following a report of 25 HCWs working in 11 general hospitals in Malaysia who were infected with TB in 2004 being publicised in the media recently. As the disease burden in general is high in Malaysia, due attention should be given to this disease in our healthcare facilities including the radiology department, an often neglected area in TB infection control programmes. This article focuses on the key control measures that can be implemented in radiology departments in a developing country with limited resources.
    Matched MeSH terms: Hospitals, General
  6. Fulltext Mumps encephalomyelitis
    Tan KK, Manickam WD, Cardosa MJ
    Singapore Med J, 1992 Oct;33(5):525-6.
    PMID: 1455285
    A 7-year-old Indian girl developed complete paralysis of her lower limbs and acute urinary retention 10 days after suffering from mumps. Encephalomyelitis due to mumps was not suspected initially since it is a rare complication of mumps, although relatively well-documented. However, the preceding history of parotitis and the presence of mumps-specific IgM in both blood and cerebrospinal fluid led to the diagnosis. The initially severe acute neurological deficits resolved completely three months after onset of her illness. Serological investigations were helpful in diagnosing neurological complications of mumps in this case, and especially where there is no preceding parotitis.
    Keywords: Mumps, encephalomyelitis, infection, Pulau Pinang, general hospital, Malaysia
    Matched MeSH terms: Hospitals, General
  7. Fulltext Single dose antacid therapy before caesarian section
    Tan KH
    Med J Malaysia, 1984 Sep;39(3):246-9.
    PMID: 6100563
    The severity of pulmonary aspiration depends mainly on the acidity of the aspirate. Mist magnesium trisilicate (MMT) has been used for many years at the maternity unit in General Hospital, Kuala Lumpur, to neutralise the acidic gastric contents in all obstetric patients requiring caesarian section. This preliminary study shows that a single dose of 15 mls of MMT before general anaesthesia raises the intragastric pH to above the critical level of 2.5 in 80% of the patients. Recently there have been doubts over the protective role of MMT. Sodium citrate which is the other antacid available may be a better alternative.
    Matched MeSH terms: Hospitals, General
  8. Fulltext Standard of care for type 2 diabetic patients in a public hospital general medical clinic: report of a self-audit
    Tan F, Chan G, Wong JS, Rozario F
    Med J Malaysia, 2008 Aug;63(3):224-8.
    PMID: 19248695 MyJurnal
    We audited the standard of care provided to 200 consecutive type 2 diabetic patients attending our hospital general medical clinic. Data on diabetes related processes and outcome measures were collected. Annual testing rates (blood pressure 100%, fasting lipid profile 91.8%, HbA1c 69%) were higher compared to complications screening rates (Eye 69%, albuminuria 51%, foot 22.4%). Lifestyle intervention was lacking with BMI documented in 38.3% of patients and smoking history in 46%. Fifty percent and 41% of patients with HbA1c > 7.5% were referred to diabetes educator and dietitian respectively. For outcome measures, 26% of patients achieved HbA1c < or = 7%, 33% achieved BP < or = 130/80 while 56% achieved LDL < or = 2.6 mmol/L. Aspirin was prescribed in 78% and ACE inhibitor or angiotensin receptor blocker in 91.8% of patients. Lifestyle intervention and complication screening are the two major areas of deficiencies in the care of type 2 diabetic patients in our hospital general medical clinic.
    Study site: General medical clinic, Sarawak General Hospital, Kuching, Sarawak, Malaysia
    Matched MeSH terms: Hospitals, General*
  9. Fulltext 16 cases of acute renal failure due to leptospirosis
    Tan DSK, Suleiman AB, Jeyaindran S
    Med J Malaysia, 1986 Jun;41(2):152-5.
    PMID: 3821611
    A study was carried out on 16 cases of leptospirosis with acute renal failure (ARF) detected in adult patients admitted into the Medical and Nephrology wards of the General Hospital, Kuala Lumpur, over a four-year period from 1980 to 1983. Most of the cases were male, Malays and older adults. The predominant infecting serovars were L. celledoni (of the serogroup L. javanica and L. pomona (of the L. pomona serogroup]. All the cases survived, including those who required peritoneal dialysis. The sensitised erythrocyte lysis (SEL) antibody prevalence rate of the chronic renal failure cases (10.4%) was found to be similar to that of the healthy population in West Malaysia (12. 7%), confirming the observation by other workers that leptospirosis is not an important cause of chronic renal failure.
    Matched MeSH terms: Hospitals, General
  10. INR Control of Patients with Mechanical Heart Valve on Long-Term Warfarin Therapy
    Tan CSY, Fong AYY, Jong YH, Ong TK
    Glob Heart, 2018 12;13(4):241-244.
    PMID: 30213574 DOI: 10.1016/j.gheart.2018.08.003
    BACKGROUND: Warfarin is an anticoagulant indicated for patients who had undergone mechanical heart valve(s) replacement (MHVR). In these patients, time in therapeutic range (TTR) is important in predicting the bleeding and thrombotic risks.
    OBJECTIVE: This study aimed to describe the anticoagulation control of warfarin using TTR in patients with MHVR in a tertiary health care referral Center.
    METHODS: Data were collected retrospectively by reviewing clinical notes of outpatients who attended international normalized ratio (INR) clinics in November 2015. Patients who had MHVR and who took warfarin were included. The data collected were demographics, relevant laboratory investigations, and patients' prior medical history. TTR was calculated using Rosendaal and traditional methods.
    RESULTS: A total of 103 patients with MHVR were recruited. The mean age was 51.72 ± 13.97 years and 46.6% were male. A total of 54.4% had mitral valve replacement (MVR), whereas 26.2% had aortic valve replacement (AVR). The mean TTR calculated using the Rosendaal method was 57.1%. There was no significant difference among patients with AVR, MVR, and both valves (AMVR) in terms of TTR (AVR vs. MVR vs. AMVR, 62.94 ± 23.08, 54.12 ± 21.62, 57.63 ± 17.47; p = 0.213). The average dose of warfarin for all groups was approximately 3 mg/day. Moreover, MVR, AVR, and AMVR patients who had TTR (Rosendaal method) ≤60% were 58.9%, 37.0%, and 45.0%, respectively. Only 4.8% had minor bleeding, whereas none had stroke in the period of TTR determination.
    CONCLUSIONS: Despite a majority of patients having <60% TTR, there were low incidences of bleeding and stroke events in this center. There were no factors found to be associated with INR control in this study.
    Study site: INR clinic, Sarawak Heart Centre, Sarawak General Hospital, Malaysia
    Matched MeSH terms: Hospitals, General
  11. Fulltext Percutaneous dilational tracheostomy--a 3 year experience in a general hospital in Malaysia
    Tan CC, Lee HS, Balan S
    Med J Malaysia, 2004 Dec;59(5):591-7.
    PMID: 15889560
    All percutaneous tracheostomies performed in the general intensive care unit (ICU), Hospital Sultanah Aminah, Johor Bahru, Malaysia, from July 1999 to June 2002 were studied. The tracheostomies were performed as an elective bedside technique in the ICU. A total of 352 percutaneous tracheostomies were performed. Eighty-eight percent of the tracheostomies were completed within 15 minutes. The most common complication was bleeding which occurred in 52 patients (14.7%). The rest of the complications encountered were:- transient hypoxia twelve (3.4%), inability/ difficulty to insert tracheostomy tube eight (2.3%), false passage four (1.1%), transient hypotension two (0.6%), pneumothorax two (0.6%), peristomal infection two (0.6%), subcutaneous emphysema one (0.3%), cuff rupture one (0.3%), oesophageal cannulation one (0.3%), and granuloma formation one (0.3%). Conversion to conventional tracheostomies were performed on 7 patients (2%). There was one unfortunate death related to percutaneous tracheostomy. In conclusion, percutaneous dilational tracheostomy can be used safely to manage the airway of critically ill patients.
    Matched MeSH terms: Hospitals, General
  12. Fulltext Chemotherapy extravasation at Hospital Pulau Pinang, Malaysia
    Tan AL, Phua VC
    Med J Malaysia, 2014 Jun;69(3):124-5.
    PMID: 25326352 MyJurnal
    PURPOSE: Extravasation with intravenous chemotherapy is a common complication of chemotherapy which carries the risk of devastating complications. This study aims to determine the rate of extravasation with intravenous chemotherapy in a major hospital where chemotherapy is delivered in various departments other than the oncology department.

    PATIENTS AND METHODS: All patients who underwent intravenous chemotherapy in the oncology department and surgical wards in Penang General hospital from 1st February 2008 till 31st June 2008 were recruited retrospectively for this study to look at the rate of extravasation.

    RESULTS: A total of 602 patients underwent intravenous chemotherapy during this period. Fifty patients received chemotherapy in the general surgical ward while another 552 patients received chemotherapy in the oncology department. There were 5 cases of extravasation giving an overall extravasation rate of 0.8% (5/602). however, 4 of these cases occurred in the general surgical ward giving it a rate of 8% (4/50).

    CONCLUSION: The rate of extravasation in our hospital was 0.8%. however, this rate can be significantly increased if it is not done under a specialized unit delivering intravenous chemotherapy on a regular basis. Preventive steps including a standard chemotherapy delivery protocol, staff and patient education must be put in place in all units delivering intravenous chemotherapy.
    Matched MeSH terms: Hospitals, General
  13. Fulltext Comparison between the panoptic ophthalmoscope and the conventional direct ophthalmoscope in the detection of sight threatening diabetic retinopathy: the kuching diabetic eye study
    Tan AK, Mallika P. S., Aziz S, Asokumaran T, Intan G, Faridah HA
    Malays Fam Physician, 2010;5(2):83-90.
    PMID: 25606193 MyJurnal
    OBJECTIVE: To determine the sensitivity and specificity of the conventional direct ophthalmoscope and the PanOptic ophthalmoscope in the detection of sight threatening retinopathy, as well as the "Ease of Use" of these equipments.
    METHODS: 200 diabetics, newly referred from primary health physicians were examined. Fundus examinations were performed with pupil dilatation in a dark room. The examinations were performed by a single investigator using the PanOptic ophthalmoscope, the conventional direct ophthalmoscope and slit lamp biomicroscopy.
    RESULTS: The overall sensitivity in detecting sight threatening retinopathy using the conventional direct ophthalmoscope was 73.2% (95% CI: 57.1-85.8%), specificity 93.7% (95% CI: 88.7-96.9%). For PanOptic ophthalmoscope, the overall sensitivity in detecting sight threatening retinopathy was 58.5% (95% CI: 42.1-73.7%), specificity 93.7% (95% CI: 88.7-96.9%). The conventional direct ophthalmoscope was 1.38 times (95% CI: 1.17-1.61 times) as easy to use compared to the PanOptic ophthalmoscope.
    CONCLUSION: The PanOptic ophthalmoscope is not superior to the conventional direct ophthalmoscope for the screening of Sight Threatening Retinopathy.
    KEYWORDS: PanOptic ophthalmoscope; conventional direct ophthalmoscope; sight threatening retinopathy
    Study site: Ophthalmology clinic, Sarawak General Hospital, Kuching, Sarawak, Malaysia
    Matched MeSH terms: Hospitals, General
  14. Fulltext Risk factors for infection in total knee replacement surgery at Hospital Kuala Lumpur
    Syahrizal AB, Kareem BA, Anbanadan S, Harwant S
    Med J Malaysia, 2001 Dec;56 Suppl D:5-8.
    PMID: 14569758 MyJurnal
    One hundred primary TKR surgeries done between January 1994 and December 1999 were reviewed after a mean follow-up of 37.4 months. The rate of superficial and deep wound infection were 2% and 9% respectively. The most common organism in wound infection was Staphylococcus aureus. The factors that were significantly associated with superficial wound infection were diabetes mellitus (p = 0.005) and rheumatoid arthritis (p = 0.0000). The factors that were significantly associated with deep wound infection were diabetes mellitus (p = 0.000). There was no significant difference between duration of surgery, and the mean age among patients with and without wound infections.
    Matched MeSH terms: Hospitals, General
  15. Fulltext Association between dietary fibre and cancer: A case-control study in Malaysia
    Suzana S, Azhar Y, Fatimah A
    Malays J Nutr, 2004 Sep;10(2):173-82.
    PMID: 22691738 MyJurnal
    A case control study to determine the association of dietary fibre and cancer among Malaysians. It was conducted among 100 newly-diagnosed cancer patients admitted to the Radiotherapy and Oncology Ward, Hospital Kuala Lumpur. A total of 100 controls matched with the cases for age, sex and ethnic origin were selected from the Outpatient Health Clinic in Sentul. The subjects were interviewed to obtain information on their habitual dietary intakes and lifestyles. Family history of cancer, smoking habits, and alcohol consumption were found to be significant risk factors for cancer (p<0.05 for all parameters). The mean intake of total energy was higher among men with nasopharyngeal cancer and women with gastrointestinal cancer as compared to their controls (p<0.05 for both parameters). The percentage of energy contribution from fat was higher among cases (35%) than controls (32.1%). The mean dietary fibre intake among cases (10.86 ± 8.90 g/d) was apparently lower than the controls (13.22 ± 5.99 g/d), with significant differences noted for breast cancer and also nasopharyngeal cancer. Women with low fibre intake (<10g/d) had a 2.2 times higher risk of getting breast cancer. There is a need to educate the public to adhere to a wholesome diet, in particular to increase the consumption of high-fibre food for disease prevention.

    Study site: Radiotherapy and Oncology Ward, Hospital Kuala Lumpur and Outpatient Health Clinic in Sentu
    Matched MeSH terms: Hospitals, General
  16. Fall risk prevention: The related factors of nurses practice at general local hospital in Indonesia
    Suryani L, Perdani AL, Dioso RI, Hoon LS
    Enferm Clin, 2020 06;30 Suppl 5:221-223.
    PMID: 32713575 DOI: 10.1016/j.enfcli.2019.11.059
    OBJECTIVE: This study aimed was to describe related factors of nurse practice in preventing fall risk in an inpatient ward at X General Local Hospital.

    METHOD: A descriptive, analytical quantitative with a cross-sectional approach was used in this study. The total of 95 nurses agreed to participate by using random sampling. Data collection using a structured questionnaire and observational form. The statistical model with a chi-square analysis was used in this study.

    RESULTS: The result showed a correlation between knowledge and nurse practice with OR 3.257 (1.375-7.715; p=0.012), attitude and nurse practice with OR 4.286 (1.775-10.345; p=0.002) training and nurse practicewith OR value 5.455 (2.233-13.322; p=0.000).

    CONCLUSIONS: Local authority in the hospital must apply patient safety standards to reduce injury rates, both nurses and patients. Nurses need to follow the current trend of nursing science focusing on patient safety.

    Matched MeSH terms: Hospitals, General
  17. Fulltext Chronic hepatitis C--a study of 105 cases between 1990-2000
    Suresh RL, Kananathan R, Merican I
    Med J Malaysia, 2001 Jun;56(2):243-7.
    PMID: 11771088
    An analysis of 105 consecutive patients with chronic hepatitis C at the gastroenterology outpatient's clinic in Hospital Kuala Lumpur was performed. The clinical, laboratory and virological data was prospectively recorded in the case notes and comprised of data on patient characteristics, risk factors, clinical features, laboratory features, virology screen and management. Chronic Hepatitis C cases accounted for 2.1% of the total number of cases seen at this clinic during the entire period. There were 78 (74%) males and 27 (26%) females. The ethnic breakdown consisted of Chinese (44.2%), Malays (39.4%), Indians (15.4%) and others (1%). There was higher male preponderance in all the ethnic groups. The main mode of transmission was blood transfusion comprising 51 patients (48.8%). A total of 35.2% of cases underwent treatment, of which a proportion had interferon monotherapy for 6 or 12 months and a subsequent group of naïve patients and non-responders underwent combination therapy with interferon and ribavarin.
    Matched MeSH terms: Hospitals, General
  18. Serum Ferritin Levels: A Potential Biomarker to Represent Child-Turcotte-Pugh Score among Decompensated Liver Cirrhosis Patients
    Sungkar T, Rozi MF, Dairi LB, Zain LH
    Malays J Med Sci, 2019 Mar;26(2):59-65.
    PMID: 31447609 DOI: 10.21315/mjms2019.26.2.7
    Background: Liver cirrhosis and the child-Turcotte-Pugh (CTP) score are inseparable entities in liver disease. CTP score is largely known as the mortality and prognosis predictor. Nevertheless, ferritin emerges as a simple biomarker related to prognosis. The study aimed to determine whether there was a significant correlation between serum ferritin levels and CTP score.

    Methods: The study analysed 54 decompensated liver cirrhotic patients including 17 females and 37 males between May 2016 and May 2017 at the Haji Adam Malik General Hospital, Medan, Indonesia. Ferritin levels were, then, divided into trichotomous cut-off value (< 200 ng/mL, n = 22; 200-400 ng/mL, n = 5; and > 400 ng/mL, n = 27). Data was analysed using SPSS version 12.0 (continuous variables were assessed by the Kruskal-Wallis test and Chi-square test was used for categorical variables). In addition, Spearman correlation test was used to determine any significant correlation between ferritin levels and CTP score.

    Results: Based on data analysis, gender and CTP score were related to higher ferritin levels (P = 0.002 and P = 0.018, respectively). Furthermore, a significant correlation between serum ferritin levels and CTP score was obtained in to moderate degree (P = 0.000; r = 0.487).

    Conclusions: There might be a significant role of serum ferritin levels in predicting mortality and prognosis among decompensated liver cirrhosis patients but it still needs further attention.

    Matched MeSH terms: Hospitals, General
  19. Fulltext Mixed lymphocyte culture (MLC) test and living related donor kidney transplantation
    Suleiman AB, Mohd Zaher ZM, Chan SH, Awang H
    Med J Malaysia, 1984 Mar;39(1):56-8.
    PMID: 6239969
    The MtC tests performed prospectively was correlated with graft survival in 73 living, related grafts. The MLC was expressed as the relative response (RR), and graft survival assessed at six months, one year and two years. The l-haplotype matched grafts with high RR had poorer graft survival at one and two years than those with low RR, but this difference was not statistically significant.
    Matched MeSH terms: Hospitals, General
  20. Fulltext Bilateral stones and renal failure
    Suleiman AB, Awang H, Proehoeman F
    Med J Malaysia, 1981 Mar;36(1):14-6.
    PMID: 7321931
    The clinical presentation of patients with bilateral stones is discussed. The majority of patients presenting to the Nephrology Unit were in renal failure. Aggressive medical treatment allowed
    diagnostic procedures and definitive surgery to be performed in uraemic patients. Most patients presenting in uraemia benefitted from treatment.
    Study Site: Urology Unit, General Hospital, Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, General
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