MyMedR

Fulltext Clinical presentation, severity and progression of primary angle closure in malays

Liza-Sharmini AT, Sharina YN, Dolaboladi AJ, Zaid NA, Azhany Y, Zunaina E

Med J Malaysia, 2014 Feb;69(1):21-6.

INTRODUCTION: There is limited knowledge on primary angle closure (PAC) in Malays. Understanding the clinical presentation and progression of PAC in Malays is important for prevention of blindness in Southeast Asia.

MATERIAL AND METHODS: A retrospective record review study was conducted on Malay patients seen in the eye clinic of two tertiary hospitals in Kelantan, Malaysia. Based on the available data, Malay patients re-diagnosed as primary angle closure suspect (PACS), primary angle closure (PAC), and primary angle closure glaucoma (PACG) based on the International Society Geographical Epidemiological classification. Clinical data was collected from initial presentation including the presence of acute primary angle closure until at least 5 years follow up. Progression was defined based on gonioscopic changes, vertical cup to disc ratio (VCDR), intraocular pressure (IOP) and Humphrey visual field (HVF) analysis. Progression and severity of PACG was defined based Hodapp-Parrish-Anderson classification on reliable HVF central 24-2 or 30-2 analysis.

RESULTS: A total of 100 patients (200 eyes) with at least 5 years follow up were included. 94 eyes (47%) presented with APAC. During initial presentation, 135 eyes (67.5%) were diagnosed with glaucomatous changes with 91 eyes already blind. After 5 years of follow up, 155 eyes (77.5%) progressed. There was 4 times risk of progression in eyes with PAC (p=0.071) and 16 times risk of progression in PACG (p=0.001). Absence of laser peripheral iridotomy was associated with 10 times the risk of progression.

CONCLUSION: Angle closure is common in Malays. Majority presented with optic neuropathy at the initial presentation and progressed further. Preventive measures including promoting public awareness among Malay population is important to prevent blindness.

Study site: Eye clinic, Hospital Universiti Sains Malaysia and Hospital
Raja Perempuan Zainab II

Matched MeSH terms: Retrospective Studies

Fulltext Role of laparoscopy and ultrasound in the management of "impalpable testis" in children

Budianto IR, Tan HL, Kinoshita Y, Tamba RP, Leiri S, Taguchi T

Asian J Surg, 2014 Oct;37(4):200-4.

PMID: 24661449 DOI: 10.1016/j.asjsur.2014.01.013

Undescended testes is one of the most common congenital abnormalities in boys. In cases of impalpable testes, ultrasound is often used to find the testis, which frequently provides false-negative results. Recently, laparoscopy has become popular in the management of impalpable testes.

Matched MeSH terms: Retrospective Studies

Fulltext Variable outcome for epilepsy after neonatal hypoglycaemia

Fong CY, Harvey AS

Dev Med Child Neurol, 2014 Nov;56(11):1093-9.

PMID: 24861161 DOI: 10.1111/dmcn.12496

To evaluate the electroclinical features of epilepsy secondary to neonatal hypoglycaemia.

Matched MeSH terms: Retrospective Studies

Fulltext Walking on thin ice! Identifying methamphetamine "drug mules" on digital plain radiography

Abdul Rashid SN, Mohamad Saini SB, Abdul Hamid S, Muhammad SJ, Mahmud R, Thali MJ, et al.

Br J Radiol, 2014 Apr;87(1036):20130472.

PMID: 24472728 DOI: 10.1259/bjr.20130472

The purpose of this study was to retrospectively evaluate the sensitivity, specificity and accuracy of identifying methamphetamine (MA) internal payloads in "drug mules" by plain abdominal digital radiography (DR).

Matched MeSH terms: Retrospective Studies

Epidemiology and survival of hepatocellular carcinoma in north-east Peninsular Malaysia

Norsa'adah B, Nurhazalini-Zayani CG

Asian Pac J Cancer Prev, 2013;14(11):6955-9.

PMID: 24377632

The incidence of hepatocellular carcinoma (HCC) is relatively high in Southeast Asia. Globally, HCC has a high fatality rate and short survival. The objectives of this retrospective cohort study were to review the epidemiology and survival of HCC patients at a tertiary centre in north-east of Peninsular Malaysia. Subjects were adult HCC patients diagnosed by histopathology or radio-imaging. Secondary liver carcinoma was excluded. Kaplan Meier and multiple Cox proportional hazard survival analyses were used. Only 210 HCC cases from years 1987-2008, were included in the final analysis. The number of cases was increasing annually. The mean age was 55.0 (SD 13.9) years with male:female ratio of 3.7:1. Approximately 57.6% had positive hepatitis B virus, 2.4% hepatitis C virus, 20% liver cirrhosis and 8.1% chronic liver disease. Only 2.9% had family history and 9.0% had frequently consumed alcohol. Most patients presented with abdominal pain or discomfort and had hepatomegaly, 47.9% had an elevated α-fetoprotein level of 800 IU/ml or more, 51.9% had multiple tumors and 44.8% involved multiple liver lobes. Approximately 63.3% were in stage 3 and 23.4% in stage 4, and 82.9% did not receive any treatment. The overall median survival time was 1.9 months (95% confidence interval (CI): 1.5, 2.3). The 1-month, 6-month, 1-year and 2-year survival rates were 71.8%, 23.3%, 13.0% and 7.3% respectively. Significant prognostic factors were Malay ethnicity [Adjusted hazard ratio (AHR) 1.6; 95%CI: 1.0, 2.5; p=0.030], no chemotherapy [AHR 1.7; 95%CI: 1.1, 2.5; p=0.017] and Child-Pugh class C [AHR 2.6; 95%CI: 1.4, 4.9; p=0.002]. HCC in our study affected a wide age range, mostly male, in advanced stage of disease, with no treatment and very low survival rates. Primary prevention should be advocated in view of late presentation and difficulty of treatment. Vaccination of hepatitis virus and avoidance of liver toxins are to be encouraged.

Matched MeSH terms: Retrospective Studies

Survival rate of breast cancer patients in Malaysia: a population-based study

Abdullah NA, Wan Mahiyuddin WR, Muhammad NA, Ali ZM, Ibrahim L, Ibrahim Tamim NS, et al.

Asian Pac J Cancer Prev, 2013;14(8):4591-4.

PMID: 24083707

Breast cancer is the most common cancer among Malaysian women. Other than hospital-based results, there are no documented population-based survival rates of Malaysian women for breast cancers. This population- based retrospective cohort study was therefore conducted. Data were obtained from Health Informatics Centre, Ministry of Health Malaysia, National Cancer Registry and National Registration Department for the period from 1st Jan 2000 to 31st December 2005. Cases were captured by ICD-10 and linked to death certificates to identify the status. Only complete data were analysed. Survival time was calculated from the estimated date of diagnosis to the date of death or date of loss to follow-up. Observed survival rates were estimated by Kaplan- Meier method using SPSS Statistical Software version 17. A total of 10,230 complete data sets were analysed. The mean age at diagnosis was 50.6 years old. The overall 5-year survival rate was 49% with median survival time of 68.1 months. Indian women had a higher survival rate of 54% compared to Chinese women (49%) and Malays (45%). The overall 5-year survival rate of breast cancer patient among Malaysian women was still low for the cohort of 2000 to 2005 as compared to survival rates in developed nations. Therefore, it is necessary to enhance the strategies for early detection and intervention.

Matched MeSH terms: Retrospective Studies

Measurement of dengue epidemic spreading pattern using density analysis method: retrospective spatial statistical study of dengue in Subang Jaya, Malaysia, 2006-2010

Dom NC, Ahmad AH, Latif ZA, Ismail R

Trans R Soc Trop Med Hyg, 2013 Nov;107(11):715-22.

PMID: 24062522 DOI: 10.1093/trstmh/trt073

Dengue has emerged as one of the major public health problems in Malaysia. The Ministry of Health, Malaysia, is committed in monitoring and controlling this disease for many years. The objective of this study is to analyze the dengue outbreak pattern on a monthly basis in Subang Jaya in terms of their spatial dissemination and hotspot identification.

Matched MeSH terms: Retrospective Studies

Fluorescence-in-situ-hybridization in the surveillance of urothelial cancers: can use of cystoscopy or ureteroscopy be deferred?

Ho CC, Tan WP, Pathmanathan R, Tan WK, Tan HM

Asian Pac J Cancer Prev, 2013;14(7):4057-9.

PMID: 23991952

BACKGROUND: Fluorescence in situ hybridization (FISH) testing may be useful to screen for bladder carcinoma or dysplasia by detecting aneuploidy chromosomes 3, 7, 17 and deletion of the chromosome 9p21 locus in urine specimens. This study aimed to assess the sensitivity, specificity, positive and negative predictive value of FISH in a multi-ethnic population in Asia.

MATERIALS AND METHODS: Patients with haematuria and/or past history of urothelial cancer on follow-up had their voided urine tested with FISH. Patients then underwent cystoscopy/ ureteroscopy and any lesions seen were biopsied. The histopathological reports of the bladder or ureteroscopic mucosal biopsies were then compared with the FISH test results.

RESULTS: Two hundred sixty patients were recruited. The sensitivity and specificity of the FISH test was 89.2% and 83.4% respectively. The positive (PPV) and negative predictive values (NPV) were 47.1% and 97.9%. By excluding patients who had positive deletion of chromosome 9, the overall results of the screening test improved: sensitivity 84.6%; specificity 96.4%; PPV 75.9% and NPV 97.9%.

CONCLUSIONS: UroVysion FISH has a high specificity of detecting urothelial cancer or dysplasia when deletion of chromosome 9 is excluded. Negative UroVysion FISH-tests may allow us to conserve health resources and minimize trauma by deferring cystoscopic or ureteroscopic examination.

Matched MeSH terms: Retrospective Studies

Fulltext The influence of pre-admission tracks on students' academic performance in a medical programme: Universiti Sains Malaysia

Arzuman H, Ja'afar R, Fakri NM

Educ Health (Abingdon), 2012 Nov;25(2):124-7.

PMID: 23823596 DOI: 10.4103/1357-6283.103460

An aim of medical schools is to select the most suitable candidates who are more likely to become good doctors, fulfilling societal expectations. It is imperative to better understand the influence of 'selection' variables on students' academic performance. We conducted a retrospective record review (3R) to examine the predictive power of pre-admission tracks on academic performance in the medical programme at the Universiti Sains Malaysia.

Matched MeSH terms: Retrospective Studies

Fulltext Teaching medical students neonatal resuscitation: knowledge gained and retained from a brief simulation-based training workshop

Lai NM, Ngim CF, Fullerton PD

Educ Health (Abingdon), 2012 Nov;25(2):105-10.

PMID: 23823593 DOI: 10.4103/1357-6283.103457

Despite being an essential clinical skill, many junior doctors feel unprepared to perform neonatal resuscitation. We introduced a neonatal resuscitation training workshop in 2009 for our final-year medical students.

Matched MeSH terms: Retrospective Studies

Identifying factors associated with diagnostic concordance/discordance in oral lichen planus

Siar CH, Lim JS, Tang SP, Chia HS, Loh YM, Ng KH

J Oral Maxillofac Surg, 2013 Oct;71(10):1688-93.

PMID: 23773425 DOI: 10.1016/j.joms.2013.04.026

To identify factors associated with concordance and discordance between clinical and histopathologic diagnoses of oral lichen planus lesions.

Matched MeSH terms: Retrospective Studies

Fulltext Correlation between lipid profile and troponin I test results in patients with chest pain in Nepal

Kumar A, Sathian B

Asian Pac J Trop Biomed, 2013 Jun;3(6):487-91.

PMID: 23730563 DOI: 10.1016/S2221-1691(13)60101-X

To study the usefulness of traditional lipid profile levels in screening subjects who had developed chest pain due to cardiac event as indicated by a positive troponin I test.

Matched MeSH terms: Retrospective Studies

Fulltext Dermatitis caused by Paederus fuscipes Curtis, 1840 (Coleoptera: Staphilinidae) in student hostels in Selangor, Malaysia

Heo CC, Latif B, Hafiz WM, Zhou HZ

Southeast Asian J. Trop. Med. Public Health, 2013 Mar;44(2):197-205.

PMID: 23691629

We report a series of dermatitis cases caused by the staphilinid beetles, Paederusfuscipes Curtis, among university students staying in the residential college in Puncak Alam, Selangor, Malaysia from 1 January to 31 December 2010. A total of 360 cases (6.0%) were recorded in the Student Health Center throughout the year; the majority of patients stayed at a hostel near an oil palm plantation. Skin symptoms included erythema, edema, vesicular papules, painful blisters, burning sensation, pruritus, hyper pigmentation and peeling of skin. The commonly involved sites were the face, neck, shoulders and arms. Most students noticed the symptoms upon awakening in the morning. The patients were treated with fusidic acid cream and the symptoms resolved within 5 days. These beetles are nocturnally active and enter the room whenever a light source is available. The unintentional crushing of these beetles during sleep causes the release of its hemolymph (paederin) which is the cause of the dermatitis.

Matched MeSH terms: Retrospective Studies

Fulltext Review of Dengue hemorrhagic fever fatal cases seen among adults: a retrospective study

Sam SS, Omar SF, Teoh BT, Abd-Jamil J, AbuBakar S

PLoS Negl Trop Dis, 2013;7(5):e2194.

PMID: 23658849 DOI: 10.1371/journal.pntd.0002194

Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The disease affects mainly children, but in recent years it is becoming more of an adult disease. Malaysia experienced a large dengue outbreak in 2006 to 2007, involving mostly adults, with a high number of deaths.

Matched MeSH terms: Retrospective Studies

Fulltext Prevalence of asymptomatic atrial fibrillation in Malaysian patients with hypertension

Wong JS, Bau R, Ahmad F, Ismail R, Yip AFY

Med J Malaysia, 2013 Apr;68(2):141-3.

PMID: 23629560 MyJurnal

Atrial fibrillation (AF) is usually asymptomatic and often associated with established cardiovascular risk factors such as hypertension. The prevalence atrial fibrillation in patients admitted to Malaysian hospitals has been determined, but asymptomatic atrial fibrillation (AAF) in hypertensive patients in the primary care setting is not established. This study reports the prevalence of AAF in hypertensive patients in Malaysia, in a primary care setting. The overall prevalence of AAF was 0.75% with no differences between the gender. The prevalence of AAF increases with age - in the age groups of 30-39, >40-49, >50-59, >60-69, 70-79 and >80 years old were 0%, 0.17%, 0.35%, 2.32%, 2.59%, and 0% respectively. Hypertensive patients with age of ≥ 61 year old were associated with a probability of 10.6 times higher for AAF. We suggest the age threshold to screen for AAF to be age of 60. It is estimated that there are 49,029 Malaysians with AAF in 2010. A large population is at risk of AAF-related complications. There is justification for an even greater emphasis on diagnostic, primary and secondary prevention strategies.
Study site: Klinik Kesihatan Bintulu, Sarawak, Malaysia

Matched MeSH terms: Retrospective Studies

Fulltext Association of creatinine clearance with neutropenia in breast cancer patients undergoing chemotherapy with fluorouracil, doxorubicin, and cyclophosphamide (FAC)

Montoya JE, Luna HG, Morelos AB, Catedral MM, Lava AL, Amparo JR, et al.

Med J Malaysia, 2013 Apr;68(2):153-6.

PMID: 23629563

Fluorouracil, doxorubicin, cyclophosphamide protocol (FAC) is a commonly used regimen for breast cancer due to its proven efficacy, acceptable toxicity, high affordability. While hepatic insufficiency dosing for doxorubicin and fluorouracil have been set, there is paucity of data in the literature on how to reduce doses in renal insufficiency. We sought to determine whether there is an association with pre-chemotherapy creatinine clearance, and the occurrence of clinically significant grade 3 to 5 neutropenia during the course of FAC chemotherapy.

Matched MeSH terms: Retrospective Studies

Behavioral and emotional problems in a Kuala Lumpur children's home

Abd Rahman FN, Mohd Daud TI, Nik Jaafar NR, Shah SA, Tan SM, Wan Ismail WS

Pediatr Int, 2013 Aug;55(4):422-7.

PMID: 23617604 DOI: 10.1111/ped.12115

There is a dearth of studies on behavioral and emotional problems in residential care children in Malaysia. This study describes the behavioral and emotional problems in a sample of children in a government residential care home and compares them with their classmates living with their birth parents.

Matched MeSH terms: Retrospective Studies

Maxillofacial injuries and traumatic brain injury--a pilot study

Rajandram RK, Syed Omar SN, Rashdi MF, Abdul Jabar MN

Dent Traumatol, 2014 Apr;30(2):128-32.

PMID: 23782407 DOI: 10.1111/edt.12052

Maxillofacial injuries comprising hard tissue as well as soft tissue injuries can be associated with traumatic brain injuries due to the impact of forces transmitted through the head and neck. To date, the role of maxillofacial injury on brain injury has not been properly documented with some saying it has a protective function on the brain while others opposing this idea.

Matched MeSH terms: Retrospective Studies

Rate of decline of kidney function in patients with type 2 diabetes mellitus and the associated factors: a 10-year retrospective cohort study

Tan SF, Chia YC, Chinna K

Asia Pac J Public Health, 2015 Mar;27(2):NP640-9.

PMID: 23761589 DOI: 10.1177/1010539513490193

This study examines the rate of decline of estimated glomerular filtration rate (eGFR) over a 10-year period and the associated risk factors in type 2 diabetes mellitus (T2DM) patients. Medical records of T2DM patients were randomly selected. The rate of fall in eGFR (simplified modification of diet in renal disease formula) was used as a measure of decline. Univariate and multivariate analysis were performed to determine the factors associated with decline of kidney function. A total of 504 patients were selected. Mean age was 57.8 ± 9 years; 65.3% were females. The mean decline rate of eGFR was 0.89 ± 2.16 mL/min/1.73 m(2)/y. Baseline proteinuria, glycosylated hemoglobin level, duration of T2DM, and Malay race were associated with faster decline in eGFR. The expected greater deterioration in kidney function in this cohort was not seen. Treatment of proteinuria and glycemia should be optimized early to retard the decline in kidney function in patients with T2DM.
Study site: Primary care clinics, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Retrospective Studies

Estimating the five-year survival of cervical cancer patients treated in hospital universiti sains malaysia

Razak NA, Mn K, Zubairi YZ, Naing NN, Zaki NM

Asian Pac J Cancer Prev, 2013;14(2):825-8.

PMID: 23621246

OBJECTIVE: The objective of this study was to determine the five-year survival among patients with cervical cancer treated in Hospital Universiti Sains Malaysia.

METHODS: One hundred and twenty cervical cancer patients diagnosed between 1st July 1995 and 30th June 2007 were identified. Data were obtained from medical records. The survival probability was determined using the Kaplan-Meier method and the log-rank test was applied to compare the survival distribution between groups.

RESULTS: The overall five-year survival was 39.7% [95%CI (Confidence Interval): 30.7, 51.3] with a median survival time of 40.8 (95%CI: 34.0, 62.0) months. The log-rank test showed that there were survival differences between the groups for the following variables: stage at diagnosis (p=0.005); and primary treatment (p=0.0242). Patients who were diagnosed at the latest stage (III-IV) were found to have the lowest survival, 18.4% (95%CI: 6.75, 50.1), compared to stage I and II where the five-year survival was 54.7% (95%CI: 38.7, 77.2) and 40.8% (95%CI: 27.7, 60.3), respectively. The five-year survival was higher in patients who received surgery [52.6% (95%CI: 37.5, 73.6)] as a primary treatment compared to the non-surgical group [33.3% (95%CI: 22.9, 48.4)].

CONCLUSION: The five-year survival of cervical cancer patients in this study was low. The survival of those diagnosed at an advanced stage was low compared to early stages. In addition, those who underwent surgery had higher survival than those who had no surgery for primary treatment.

Matched MeSH terms: Retrospective Studies

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