Displaying publications 1161 - 1180 of 1484 in total

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  1. The influence of CYP3A gene polymorphisms on cyclosporine dose requirement in renal allograft recipients
    Eng HS, Mohamed Z, Calne R, Lang CC, Mohd MA, Seet WT, et al.
    Kidney Int, 2006 May;69(10):1858-64.
    PMID: 16612333
    Cyclosporine is a substrate of cytochrome P-450 3A (CYP3A) subfamily of enzymes and characterized by a narrow therapeutic range with wide interindividual variation in pharmacokinetics. A few single-nucleotide polymorphisms detected in CYP3A genes have been shown to correlate significantly with the CYP3A protein expression and activity. We therefore postulated that these polymorphisms could be responsible for some of the interindividual variation in cyclosporine pharmacokinetics. The objective of our study is to determine correlation if any between single-nucleotide polymorphisms of CYP3A5 and CYP3AP1 on cyclosporine dose requirement and concentration-to-dose ratio in renal allograft recipients. Cyclosporine-dependent renal allograft recipients were genotyped for CYP3A5 A6986G and CYP3AP1 G-44A. The cyclosporine dosages prescribed and the corresponding cyclosporine trough levels for each patient were recorded so that cyclosporine dose per weight (mg/kg/day) and concentration-to-dose ratio (C(0)/D, whereby C(0) is trough level and D is daily dose per weight) could be calculated. A total of 67 patients were recruited for our study. The dose requirement for 1, 3, and 6 months post-transplantation ranged 2.3-11.4, 1.0-9.0, and 1.4-7.2 mg/kg/day, respectively. Patients with *1*1*1*1 (n=5) CYP3A5- and CYP3AP1-linked genotypes needed higher dose of cyclosporine compared to patients with *1*3*1*3 (n = 27) and *3*3*3*3 (n = 33) linked genotypes in months 3 and 6 post-transplantation (P < 0.016). The identification of patients with *1*1*1*1 by CYP3A5 and CYP3AP1 genotyping may have a clinically significant and positive impact on patient outcome with reduced rejection rate by providing pretransplant pharmacogenetic information for optimization of cyclosporine A dosing.
    Matched MeSH terms: Follow-Up Studies
  2. Epidermal growth factor receptor targeted therapy with gefitinib in locally advanced and metastatic primary lung adenocarcinoma
    Liam CK, Pang YK, Leow CH
    Respirology, 2006 May;11(3):287-91.
    PMID: 16635086
    To describe the efficacy of monotherapy with the epidermal growth factor receptor-tyrosine kinase inhibitor, gefitinib in patients with locally advanced and metastatic primary lung adenocarcinoma.
    Matched MeSH terms: Follow-Up Studies
  3. Fulltext COBB syndrome treated by staged intravascular embolisation and surgery
    Sayuthi S, Moret J, Pany A, Sobri A, Shafie M, Abdullah J
    Med J Malaysia, 2006 Jun;61(2):239-41.
    PMID: 16898321 MyJurnal
    A 28-year old Malay man with evidence of an upper motor neuron cord lesion was diagnosed to have a C7 to T2 spinal arterio-venous malformation and associated cutaneous vascular lesion. He finally agreed for treatment after 5 years of progressive spastic right lower limb weakness leading to inability to mobilize. A two staged intravascular procedure was done followed by surgery with recovery of ASIA impairment scale grade B.
    Matched MeSH terms: Follow-Up Studies
  4. The use of octyl cyanoacrylate (superglue) in hypospadias repair including its use as a fixator for urethral stents
    Tan HL, Nah SA, Budianto II, Sehat S, Tamba R
    J Pediatr Surg, 2012 Dec;47(12):2294-7.
    PMID: 23217892 DOI: 10.1016/j.jpedsurg.2012.09.022
    Octyl cyanoacrylate has been used for many years for simple skin closure, but its use in hypospadias repair and as a urethral stent fixator has not been previously reported. We report our experience.
    Matched MeSH terms: Follow-Up Studies
  5. Percutaneous intramedullary supracondylar nailing for fractures of distal femur
    Patel K, Kapoor A, Daveshwar R, Golwala P
    Med J Malaysia, 2004 May;59 Suppl B:206-7.
    PMID: 15468890
    A prospective study of 25 patients with supracondylar and intercondylar fracture of the femur was carried out from January 1999 to June 2003 at SSG Hospital, Baroda, India. Twenty-eight percent fractures were open and 72% were closed. Twelve pecent of the fractures had intraarticular extension. AO classification was used to classify the fractures. Eighty-four percent of the fractures were due to high velocity trauma. All the cases were operated by percutaneous supracondylar nailing. No postoperative complication related to fracture treatment was seen. Average follow up was 20.1 months (range 6-40 months). Average age of the patients was 31.5 years. Average time of union was 3.1 months (range 2-4 months). Average knee range of motion was 117 degrees. Even in open injuries, 85.7% had more than 110 infinity range of motion. All patients could return to their pre-injury lifestyle. Rating scale developed by Hospital for Special Surgery was used to quantify the results. Eighty-four percent showed excellent, 8% showed good and 8% showed fair results. Percutaneous supracondylar nailing is thus, an excellent method of treating fractures of distal femur.
    Matched MeSH terms: Follow-Up Studies
  6. Impact of cardiac care variation on ST-elevation myocardial infarction outcomes in Malaysia
    Selvarajah S, Fong AY, Selvaraj G, Haniff J, Hairi NN, Bulgiba A, et al.
    Am J Cardiol, 2013 May 1;111(9):1270-6.
    PMID: 23415636 DOI: 10.1016/j.amjcard.2013.01.271
    Developing countries face challenges in providing the best reperfusion strategy for patients with ST-segment elevation myocardial infarction because of limited resources. This causes wide variation in the provision of cardiac care. The aim of this study was to assess the impact of variation in cardiac care provision and reperfusion strategies on patient outcomes in Malaysia. Data from a prospective national registry of acute coronary syndromes were used. Thirty-day all-cause mortality in 4,562 patients with ST-segment elevation myocardial infarctions was assessed by (1) cardiac care provision (specialist vs nonspecialist centers), and (2) primary reperfusion therapy (thrombolysis or primary percutaneous coronary intervention [P-PCI]). All patients were risk adjusted by Thrombolysis In Myocardial Infarction (TIMI) risk score. Thrombolytic therapy was administered to 75% of patients with ST-segment elevation myocardial infarctions (12% prehospital and 63% in-hospital fibrinolytics), 7.6% underwent P-PCI, and the remainder received conservative management. In-hospital acute reperfusion therapy was administered to 68% and 73% of patients at specialist and nonspecialist cardiac care facilities, respectively. Timely reperfusion was low, at 24% versus 31%, respectively, for in-hospital fibrinolysis and 28% for P-PCI. Specialist centers had statistically significantly higher use of evidence-based treatments. The adjusted 30-day mortality rates for in-hospital fibrinolytics and P-PCI were 7% (95% confidence interval 5% to 9%) and 7% (95% confidence interval 3% to 11%), respectively (p = 0.75). In conclusion, variation in cardiac care provision and reperfusion strategy did not adversely affect patient outcomes. However, to further improve cardiac care, increased use of evidence-based resources, improvement in the quality of P-PCI care, and reduction in door-to-reperfusion times should be achieved.
    Matched MeSH terms: Follow-Up Studies
  7. Fulltext Tophaceous gout causing atlanto-axial subluxation mimicking rheumatoid arthritis: a case report
    Wazir NN, Moorthy V, Amalourde A, Lim HH
    J Orthop Surg (Hong Kong), 2005 Aug;13(2):203-6.
    PMID: 16131689 DOI: 10.1177/230949900501300220
    This is a case report of an extremely rare condition of atlanto-axial subluxation secondary to gouty arthritis, which mimicked rheumatoid arthritis at presentation. Gouty arthritis involving the spine is a rare condition. We highlight a case of gouty arthritis involving the atlanto-axial joint resulting in joint instability, subluxation, and neurological deficit. A 66-year-old obese woman who had a polyarticular disease for the previous 3 years presented with neck pain and progressive neurology. A 2-stage procedure was performed: posterior decompression and occipitocervical fusion followed by further anterior trans-oral decompression. However, after an initial neurological improvement, she succumbed to aspirational pneumonia and septicaemia. Atlanto-axial subluxation caused by gouty arthritis can present in the same way as rheumatoid arthritis. Therefore, the possibility of this as a differential diagnosis should be kept in mind.
    Matched MeSH terms: Follow-Up Studies
  8. Combination of vascularized outer-table calvarial bone graft based on the superficial temporal vessels and allomatrix for the repair of an orbito-frontal blow-out fracture in a child
    Ali F, Halim AS, Najihah SZ, Ibrahim M, Abdullah J
    J Craniomaxillofac Surg, 2005 Oct;33(5):326-30.
    PMID: 16125400
    A vascularized outer-table calvarial bone graft was used for repairing a Posnick type 2 traumatic orbito-frontal bone defect supported by the use of a calcium-based putty (Allomatrix) in a 7-year-old girl. Gaps between the donor and recipient sites were filled with Allomatrix containing demineralized bone matrix particles. Four years later there was a good cosmetic result using an artificial left eye.
    Matched MeSH terms: Follow-Up Studies
  9. Fulltext A comparison of valsartan and perindopril in the treatment of essential hypertension in the Malaysian population
    Bavanandan S, Morad Z, Ismail O, Chandran A, Thayaparan T, Singaraveloo M
    Med J Malaysia, 2005 Jun;60(2):158-62.
    PMID: 16114156 MyJurnal
    This study was conducted to determine the tolerability and efficacy of valsartan (DIOVAN) compared to perindopril (COVERSYL) in Malaysian patients with mild to moderate hypertension. Two hundred and fifty adult Malaysian patients with a mean sitting diastolic blood pressure of more than 95 mmHg and less than 115 mmHg after a 14 day washout period were randomized to receive either valsartan 80 mg once daily (n=125) or perindopril 4 mg daily (n=125) for eight weeks. The primary end point for efficacy was the change in mean sitting systolic and diastolic blood pressure (SiSBP and SiDBP). The primary criteria for evaluation of tolerability was the incidence of adverse events. There were no significant differences between the two groups with respect to sex, age, weight, baseline sitting and standing systolic and diastolic blood pressure. At 0, 4 and 8 weeks the mean SiDBP in the valsartan group were 101.4, 92.8 and 91.0 mmHg respectively. The corresponding BP for the perindopril treated group was 102.6, 93.8 and 93.2 mmHg. (95% CI -1.39 to +3.27). There were no significant differences in the mean BP measurements between the valsartan and perindopril group at 0, 4 and 8 weeks. In each group there were significant differences between the BP at 4 and 8 weeks compared to baseline. A similar pattern was seen with SiSBP. At 4 weeks 28.7% of the valsartan and 25% of the perindopril group had their BP normalized (SiDBP <90 mmHg) The percentages of patients who responded (SiDBP reduction >10 mmHg but SiDBP >90 mmHg) were 21.3 in the valsartan group and 20.8 in the perindopril group. At 8 weeks, 31.1% of the valsartan group and 30.8% of the perindopril group had their BP normalized. The response rate was 27% and 22.5% for valsartan and perindopril respectively. The major adverse event was cough which occurred in 18 patients (14.4%) in the perindopril and 1 (0.8%) in the valsartan group at 4 weeks. At 8 weeks the figures were 24 (19.2%) and 2 (1.6%) respectively. The results indicate that Valsartan is safe and efficacious in the treatment of mild to moderate hypertension. It is equally efficacious to Perindopril and not associated with any major adverse event. It has a better tolerability profile with respect to dry cough.
    Matched MeSH terms: Follow-Up Studies
  10. Fulltext The safety and efficacy of oral dextrose for relieving pain following venepuncture in neonates
    Ling JM, Quah BS, Van Rostenberghe H
    Med J Malaysia, 2005 Jun;60(2):140-5.
    PMID: 16114153
    The objective of this study was to assess the efficacy and safety of oral 30% dextrose during venepuncture in neonates. Neonates admitted in the Special Care Nursery for jaundice from September 200 to January 2001 were recruited for this double-blind randomised controlled trial. The intervention consisted of administration of either 2 ml of oral 30% dextrose or 2 ml of sterile water 2 minutes before venepuncture. The primary outcome measure was the cumulative Neonatal Infant Pain Scale (NIPS) score at 3 minutes after venepuncture and the duration of cry assessed from a videotaped recording. Twenty-six neonates received 30% dextrose and 26 neonates received sterile water. The cumulative NIPS score at 3 minutes (median, IQR) after venepuncture for neonates given 30% dextrose (13, 6.8-21) was significantly (p = 0.03) lower than that for neonates given sterile water (21, 13.8-21). The duration of cry in neonates given 30% dextrose (median 45 sec IQR 1.5-180.8 sec) was significantly (p = 0.03) shorter than that in neonates given sterile water (median 191 sec IQR 52.3-250 sec). No neonates developed diarrhoea, fever or rash during the 24 hour observation period. Both the intra-rater (ICC 0.993 95% CI 0.988-0.996) and inter rater (ICC 0.988 95% CI 0.980-0.993) agreement on the 3-minute NIPS score were good. In conclusion oral 30% dextrose given 2 minutes before venepuncture was effective in reducing neonatal pain following venepuncture. It is a simple, safe and fast acting analgesic and should be considered for minor invasive procedure in term neonates.
    Matched MeSH terms: Follow-Up Studies
  11. Fulltext An unusual presentation of tropical pyomyositis
    Sudha V, Abhishek M, Shashikiran U, Annappa K, Mukhyaprana MP
    Med J Malaysia, 2005 Jun;60(2):229-31.
    PMID: 16114167
    Tropical pyomyositis is a primary pyogenic infection of skeletal muscle, often caused by Staphylococcus aureus. The most common presentation of tropical pyomyositis is that of multiple acute abscesses with fever. Hepatitis is a rare manifestation of this disease. We report a case of tropical pyomyositis who presented with hepatic encephalopathy leading to initial diagnostic dilemma.
    Matched MeSH terms: Follow-Up Studies
  12. Fulltext Pulmonary metastases of giant cell tumour of the bone
    Faisham WI, Zulmi W, Saim AHM, Biswal BM
    Med J Malaysia, 2004 Dec;59 Suppl F:78-81.
    PMID: 15941172
    The clinical presentation and behaviour of giant cell tumour of bone vary. The progression of the disease and metastasis are unpredictable, but the overall prognosis is good. Six patients with pulmonary metastases of giant cell tumour have been treated at our institution since 1998. This represents 15% of all patients treated for giant cell tumour of the bone. Early detection and treatment of this tumour is important as complete resection of this tumour have favourable prognosis. Multiple lung nodules which preclude resection may remain dormant and asymptomatic with systemic chemotherapy.
    Matched MeSH terms: Follow-Up Studies
  13. Fulltext An unusual radiographic presentation of posterior cruciate ligament avulsion fracture
    Nizlan MNM, Suhail A, Samsudin OC, Masbah O
    Med J Malaysia, 2004 Dec;59 Suppl F:65-8.
    PMID: 15941168
    A case of traumatic posterior cruciate ligament (PCL) avulsion fracture presenting with unusual radiographic findings is described. CT scan of the right knee showed features suggestive of combined ACL and PCL avulsion fractures. Arthroscopic findings showed that the injury was in fact a PCL avulsion fracture that was displaced anteriorly so as to mimic an ACL avulsion fracture on CT scan.
    Matched MeSH terms: Follow-Up Studies
  14. Chemiluminescence as a diagnostic aid in the detection of oral cancer and potentially malignant epithelial lesions
    Ram S, Siar CH
    Int J Oral Maxillofac Surg, 2005 Jul;34(5):521-7.
    PMID: 16053872
    Chemiluminescence was evaluated as a diagnostic aid in the detection of oral cancer and potentially malignant epithelial lesions (PMELs) by comparing it against 1% tolonium chloride mouth rinse. Forty-six clinically identified lesions [14 primary squamous cell carcinoma (SCC), 26 PMELs and 6 benign lesions] and five cases of normal oral mucosa from 40 subjects (inclusive of 10 previously treated SCC cases) were examined with a commercial chemiluminescent kit (Vizilite) and tolonium chloride. Biopsy and histological verification of 31 lesions disclosed 14 SCC (45.2%), 10 epithelial dysplasias (32.3%), 5 lichen planus (16.1%) and 2 benign lesions (6.4%). For the remaining 15 lesions, a biopsy was not performed owing to patient's lack of consent or ill-health. The five cases of normal oral mucosa which tested negative for both tools were also not biopsied for ethical reasons. Sensitivity for Vizilite and tolonium chloride was 100% and 70.3%, respectively; and specificity was 14.2% for Vizilite and 25% for tolonium chloride. Their accuracy was 80.6% and 64.5%, respectively. Current findings suggest that chemiluminescence is a more reliable diagnostic tool than tolonium chloride in the detection of oral cancer and PMELs, and for follow-up of patients treated for the same.
    Matched MeSH terms: Follow-Up Studies
  15. Head injury from fan blades among children
    Alias A, Krishnapillai R, Teng HW, Abd Latif AZ, Adnan JS
    Asian J Surg, 2005 Jul;28(3):168-70.
    PMID: 16024308
    OBJECTIVE: Head injury caused by fan blades is rare among children. We analysed 14 cases of such injury and discuss the causes, type of injury and preventive measures.

    METHODS: A retrospective analysis of 14 cases of children who were admitted to the Pediatric Neurosurgical Unit of Hospital Kuala Lumpur after sustaining head injuries caused by fan blades between January 2000 and December 2002 was performed.

    RESULTS: The causes of fan-blade head injury included jumping on the upper bunk of a bunk-bed, climbing on a ladder, climbing up onto a table, and being lifted by an adult. Thirteen patients were injured by ceiling fans and one by falling onto an uncovered table fan. School-aged boys were the predominant victims. Mean patient age was 7.9 years (range, 1.0-12.2 years). There was a twin peak incidence of when the accidents occurred: just before lunch in the afternoon and bedtime at night. The types of injury were scalp lacerations, compound depressed fractures and multiple intracranial haemorrhages. Two patients had the complication of wound infection, and one of these patients developed cerebral spinal fluid leak. One patient died from severe head injuries.

    CONCLUSION: Safety awareness among parents and caretakers are important as fan-blade head injury among children is preventable.

    Matched MeSH terms: Follow-Up Studies
  16. Persistence of cognitive deficits following paediatric head injury without professional rehabilitation in rural East Coast Malaysia
    Abdullah JM, Kumaraswamy N, Awang N, Ghazali MM, Abdullah MR
    Asian J Surg, 2005 Jul;28(3):163-7.
    PMID: 16024307
    To use data from a prospective, longitudinal study to determine whether psychomotor functions improve spontaneously during the first year following paediatric traumatic brain injury without modern rehabilitation facilities in a rural area of Malaysia.
    Matched MeSH terms: Follow-Up Studies
  17. Addition of macrolide in treating adult hospitalized community-acquired pneumonia
    Loh LC, Quah SY, Khoo SK, Vijayasingham P, Thayaparan T
    Respirology, 2005 Jun;10(3):371-7.
    PMID: 15955152
    Current clinical practice guidelines, including those in south Asia, recommend the addition of a macrolide to a broad-spectrum antibiotic for the treatment of severe hospitalized community-acquired pneumonia (CAP). The aim of this study was to observe the influence of macrolide addition on clinical outcomes of hospitalized adult patients with CAP.
    Matched MeSH terms: Follow-Up Studies
  18. Fulltext Treatment for flexion contracture of the knee during Ilizarov reconstruction of tibia with passive knee extension splint
    Kwan MK, Penafort R, Saw A
    Med J Malaysia, 2004 Dec;59 Suppl F:39-41.
    PMID: 15941159
    Joint stiffness is one of the complications of limb procedure. It developes as a result of failure of knee flexors to lengthen in tandem with the bone, especially when there is inadequate physical therapy to provide active and passive mobilization of the affected joint. We are reporting four patients who developed fixed flexion contracture of their knees during bone lengthening procedure for the tibia with Ilizarov external fixator. Three of them were treated for congenital pseudoarthrosis and one was for fibular hemimelia. None of them were able to visit the physiotherapist even on a weekly basis. A splint was constructed from components of Ilizarov external fixator and applied on to the existing frame to passively extend the affected knee. Patients and their family members were taught to perform this exercise regularly and eventually near complete correction were achieved. With this result, we would like to recommend the use of this "Passive Knee Extension Splint" to avoid knee flexion Contracture during limb lengthening procedures with Ilizarov external fixators.
    Matched MeSH terms: Follow-Up Studies
  19. Fulltext Early complication following long bone reconstruction using vascularised fibula graft
    Imran Y, Zulmi W, Halim AS
    Med J Malaysia, 2004 Dec;59 Suppl F:35-8.
    PMID: 15941158
    Long bone reconstruction using vascularized fibula graft is becoming more popular despite the difficulties and its post-operative complications. We reviewed our early experience dealing with vascularized fibula graft for the management of massive long bone defect. Thirteen patients had undergone long bone reconstruction using vascularized fibula graft. Early complications that had been encountered include superficial wound infection (23%), transient common peroneal nerve palsy (23%), stage 1 bed sore (7.7%), anastomotic venous thrombosis (30.8%), DIVC (15.4%), flap loss and amputation (7.7%), and reactive psychiatric problem (7.7%). The early complications following this procedure are comparable with other major orthopaedic surgery and most of them are minor and treatable. The complication rates are also comparable with similar surgery done elsewhere.
    Matched MeSH terms: Follow-Up Studies
  20. Fulltext Versatility of the latissimus dorsi flap in upper limb salvage tumour surgery
    Dorai AA, Halim AS, Zulmi W
    Med J Malaysia, 2004 Dec;59 Suppl F:42-6.
    PMID: 15941160
    Reconstructive surgeons often encounter complex soft tissue and skeletal defects following oncological surgery. Soft tissue defects after wide resection in upper extremities posses a difficult challenge to find adequate tissue for reconstructing these defects. Paucity of local tissues dictates the requirement of loco-regional or distant flaps for these complex soft tissue defects which often exposes tendons, bones, nerves and joints. The latissimus dorsi muscle is a near ideal flap for the reconstruction because of the long neurovascular pedicle, ease of mobilization and its expendability. It can be rotated, with or without overlying skin, to cover soft tissue defects of the shoulder arm and elbow. Due to the large size of the muscle, it can be used to resurface the soft tissue defects and cover all major structures. Eleven consecutive cases were reviewed in which latissimus dorsi myocutaneous flap was used to reconstruct soft tissue defects of the upper limb following radical tumor resection. Flap survival was 100% with nominal donor site morbidity.
    Matched MeSH terms: Follow-Up Studies
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