MyMedR

Displaying publications 1321 - 1340 of 2022 in total

Abstract:

Sort:

Fulltext Association of non-alcoholic fatty liver disease and all-cause mortality in hospitalized cardiovascular disease patients: A systematic review and meta-analysis

Saokaew S, Kanchanasurakit S, Thawichai K, Duangprom P, Wannasri M, Khankham S, et al.

Medicine (Baltimore), 2021 Feb 05;100(5):e24557.
PMID: 33592910 DOI: 10.1097/MD.0000000000024557

BACKGROUND: Controversy remains concerning the association of the all-cause mortality risk of hospitalized cardiovascular disease (CVD) patients with non-alcoholic fatty liver disease (NAFLD). This study investigated the risks of all-cause mortality among hospitalized CVD patients with NAFLD.
METHODS: We used related keywords to search for studies in 3 electronic databases: PubMed, EMBASE, and Cochrane Library. All eligible studies published up to April 2020 were reviewed. The findings of those studies reporting the mortality outcomes of hospitalized CVD patients with and without NAFLD were examined, and the various study results were pooled and analyzed using a random-effects model. A quality assessment using the Newcastle-Ottawa scale was performed on the studies selected for inclusion in a meta-analysis.
RESULTS: A total of 2135 studies were found, of which 3 were included in this meta-analysis. All studies were considered good quality. The mean age of the patients in the analysis was 73 years, and about half of them were men. The comorbidities reported were hypertension, diabetes mellitus, and dyslipidemia. The results showed that hospitalized CVD patients with NAFLD were at a significantly higher risk of all-cause mortality than non-NAFLD patients (adjusted hazard ratio of 2.08 [95% confidence interval, 1.56-2.59], P

Matched MeSH terms: Aged, 80 and over
Colonic diverticular disease in a multiracial Asian patient population has an ethnic predilection

Rajendra S, Ho JJ

Eur J Gastroenterol Hepatol, 2005 Aug;17(8):871-5.
PMID: 16003138

BACKGROUND: Traditionally, diverticular disease of the colon has been attributed to ageing, low dietary fibre and a high intraluminal pressure. Recently, genetic and racial factors have also been implicated.
METHODS: Four-hundred and ten consecutive multiracial Asian patients undergoing colonoscopy for a variety of bowel symptoms in a private endoscopy unit were studied for differing frequencies (if any) in colonic diverticular disease and concomitant abnormalities.
RESULTS: Forty-one patients (10%) had diverticular disease. Diverticula were present in 22/147 Chinese (15%), 14/153 Indians (9%) and 5/110 Malays (4.5%). The mean age of patients with diverticular disease was 55 years as compared with 51.3 years in those without (P = 0.12) and there was no gender difference. Thirty-six patients (88%) had diverticula in the right colon only, four patients (10%) exclusively in the left hemicolon, and one patient (2%) had bilateral involvement. Using regression analysis, Chinese ethnicity [odds ratio (OR)=2.11; 95% confidence interval (CI), 1.09-4.09; P = 0.027), constipation (OR = 2.65; 95% CI, 1.23-5.42; P = 0.007) and colorectal adenomas (OR = 2.65; 95% CI, 1.08-6.46; P = 0.033) were independently associated with diverticular disease.
CONCLUSIONS: Colonic diverticular disease in a multiracial Asian patient population has an ethnic predilection and is predominantly right-sided.

Matched MeSH terms: Aged, 80 and over
The patellar tendon bar! Is it a necessary feature?

Abu Osman NA, Spence WD, Solomonidis SE, Paul JP, Weir AM

Med Eng Phys, 2010 Sep;32(7):760-5.
PMID: 20678997 DOI: 10.1016/j.medengphy.2010.04.020

The purpose of this investigation was to vary the load on the patellar tendon bar and to study the subsequent effect this has on the pattern of the pressure distribution at the stump-socket interface. Ten male subjects from the Southern General Hospital in Glasgow, UK participated in this study. Measuring systems utilising strain gauge and electrohydraulic technologies were designed, developed and constructed to enable pressure measurements to be conducted. One transducer, the patellar tendon (PT) transducer, was attached to the patellar tendon bar of the socket such that the patellar tendon bar was capable of being translated by +/-10 mm towards or away from the tendon. The results of this study showed that the position of the patellar tendon bar had no significant effect on the pressure distribution around the socket indicating that it is an unnecessary feature, which, we propose, may be eliminated during manufacture of a trans-tibial socket.

Matched MeSH terms: Aged, 80 and over
Fulltext Smokers' responses toward cigarette pack warning labels in predicting quit intention, stage of change, and self-efficacy

Fathelrahman AI, Omar M, Awang R, Borland R, Fong GT, Hammond D, et al.

Nicotine Tob Res, 2009 Mar;11(3):248-53.
PMID: 19246625 DOI: 10.1093/ntr/ntn029

This paper is concerned with the effects of cigarette pack warning labels on quitting intentions. We examined whether different responses among smokers toward cigarette pack warning labels could predict quit intentions and self-efficacy in quitting. Variables studied were "noticing warning labels during last month," "reading or looking closely at warning labels," "avoiding looking at labels during last month," "thinking about health risks of smoking because of the warning labels, "more likely to quit because of the warning labels," and "stopping from having a cigarette when about to smoke one because of the labels."

Matched MeSH terms: Aged, 80 and over
Fulltext Predominance of G to A codon 12 mutation K-ras gene in Dukes' B colorectal cancer

Zulhabri O, Rahman J, Ismail S, Isa MR, Wan Zurinah WN

Singapore Med J, 2012 Jan;53(1):26-31.
PMID: 22252179

K-ras gene mutations in codons 12 and 13 are one of the earliest events in colon carcinogenesis.

Matched MeSH terms: Aged, 80 and over
Fulltext Evaluation of bowel distension and mural visualisation using neutral oral contrast agents for multidetector-row computed tomography

Lim BK, Bux SI, Rahmat K, Lam SY, Liew YW

Singapore Med J, 2012 Nov;53(11):732-6.
PMID: 23192500

We compared the effectiveness of different types of non-commercial neutral oral contrast agents for bowel distension and mural visualisation in computed tomographic (CT) enterography.

Matched MeSH terms: Aged, 80 and over
Fulltext Cervical cancer in Brunei Darussalam

Lee MY, Telisinghe PU, Ramasamy R

Singapore Med J, 2012 Sep;53(9):604-7.
PMID: 23023903

Introduction Cervical cancer caused by the human papilloma virus (HPV) is a common cancer in women. There is no published data on the recent incidence of cervical dysplasia, cervical cancer and genital warts caused by the different types of HPVs in Brunei Darussalam.
Methods A cross-sectional, retrospective study was conducted utilising data from patients diagnosed with cervical cancer during the period 2005–2009 in Brunei Darussalam. The varying incidences of different types of cervical lesions among various ethnic and age groups, and in the overall population, were determined.
Results The mean age-standardised incidence of invasive cervical cancer during the five-year period was 24.9 per 100,000 women per year (95% confidence interval [CI] 21.7, 28.1). Age-specific invasive cervical cancer incidence peaked in the age group 45–59 years. Chinese females tended to have a higher incidence of invasive cervical cancer (28.2 per 100,000 women per year; 95% CI 17.8, 38.7) than Malay females (20.6 per 100,000 women per year; 95%
CI 17.1, 24.2), while other ethnic groups in Brunei Darussalam had a significantly lower incidence (6.5 per 100,000 women per year; 95% CI 3.0, 10.0).
Conclusion The results suggest that Brunei Darussalam has a relatively higher incidence of cervical cancer compared to its neighbouring countries. The findings support the need for more comprehensive screening, public education programmes and vaccination against HPV in the country.

Matched MeSH terms: Aged, 80 and over
Fulltext Hospitalised patients' awareness of their rights: a cross-sectional survey from a tertiary care hospital on the east coast of Peninsular Malaysia

Yousuf RM, Fauzi AR, How SH, Akter SF, Shah A

Singapore Med J, 2009 May;50(5):494-9.
PMID: 19495519

Optimal patient care varies considerably from place to place and is influenced by scientific as well as social developments. The purpose of this study was to investigate awareness and pertinent issues regarding informed consent among hospitalised patients and to determine lapses, in order to improve the standard of care.

Matched MeSH terms: Aged, 80 and over
Fulltext Male breast cancer: experience from a Malaysian tertiary centre

Ngoo KS, Rohaizak M, Naqiyah I, Shahrun Niza AS

Singapore Med J, 2009 May;50(5):519-21.
PMID: 19495524

Breast cancer is a rare condition among men with a reported incidence of about one percent. Nevertheless, it is thought to behave similarly in both genders. Due to its rarity, male breast cancer is not widely reported, especially in the Asian population.

Matched MeSH terms: Aged, 80 and over
Fulltext Predictors of major lower limb amputation among type II diabetic patients admitted for diabetic foot problems

Yusof NM, Rahman JA, Zulkifly AH, Che-Ahmad A, Khalid KA, Sulong AF, et al.

Singapore Med J, 2015 Nov;56(11):626-31.
PMID: 26668408 DOI: 10.11622/smedj.2015172

Introduction: Diabetes mellitus (DM) is the most common cause of amputations in Malaysia. This study aimed to identify the predictive factors for major lower limb amputation among patients with type 2 DM (T2DM) who were admitted to a hospital, in order to reduce its likelihood.
Methods: This cross-sectional study involved 218 patients with T2DM who were admitted to Hospital Tengku Ampuan Afzan, Kuantan, Malaysia, for diabetic foot problems from June 2011 to July 2012. A form was developed to document the patients' profiles, comorbidities, complications, investigations, treatment and clinical outcomes. The predictors for major lower limb amputations were determined using univariate and stepwise logistic regression analysis.
Results: A total of 31 patients underwent major lower limb amputations (25 transtibial, 6 transfemoral). The following factors were found to be associated with the incidence of major lower limb amputations: T2DM duration ≥ 10 years, diabetic neuropathy, diabetic nephropathy, presentation with gangrene, diabetic foot conditions of Wagner grade 4 or 5, and necrotising fasciitis. Patients who underwent major amputations had significantly lower haemoglobin and albumin levels, and higher total white blood cell counts, erythrocyte sedimentation rates, and C-reactive protein, urea and creatinine levels. However, only T2DM duration ≥ 10 years, positive bacterial culture and albumin levels were significant on stepwise logistic regression analysis.
Conclusion: T2DM duration ≥ 10 years, positive bacterial culture and low albumin levels were found to be significant predictive factors for major lower limb amputation among patients with T2DM admitted for diabetic foot problems.
Keywords: amputation; diabetes mellitus; diabetic foot; lower limb; type II.

Matched MeSH terms: Aged, 80 and over
Fulltext Cost of post-stroke outpatient care in Malaysia

Akhavan Hejazi SM, Mazlan M, Abdullah SJ, Engkasan JP

Singapore Med J, 2015 Feb;56(2):116-9.
PMID: 25715857

INTRODUCTION: This study aimed to investigate the direct cost of outpatient care for patients with stroke, as well as the relationship between the aforementioned cost and the sociodemographic and stroke characteristics of the patients.

METHODS: This was a cross-sectional study involving patients with first-ever stroke who were attending outpatient stroke rehabilitation, and their family members. Participants were interviewed using a structured questionnaire designed to obtain information regarding the cost of outpatient care. Stroke severity was measured using the National Institute of Health Stroke Scale.

RESULTS: This study comprised 49 patients (28 men, 21 women) with a mean age of 60.2 (range 35-80) years. The mean total cost incurred was USD 547.10 (range USD 53.50-4,591.60), of which 36.6% was spent on attendant care, 25.5% on medical aids, 15.1% on travel expenses, 14.1% on medical fees and 8.5% on out-of-pocket expenses. Stroke severity, age > 70 years and haemorrhagic stroke were associated with increased cost. The mean cost of attending outpatient therapy per patient was USD 17.50 per session (range USD 6.60-30.60), with travelling expenses (41.8%) forming the bulk of the cost, followed by medical fees (38.1%) and out-of-pocket expenses (10.9%). Multiple regression analysis showed that stroke severity was the main determinant of post-stroke outpatient care cost (p < 0.001).

CONCLUSION: Post-stroke outpatient care costs are significantly influenced by stroke severity. The cost of attendant care was the main cost incurred during the first three months after hospital discharge, while travelling expenses was the main cost incurred when attending outpatient stroke rehabilitation therapy.

Matched MeSH terms: Aged, 80 and over
Fulltext Effects of monochromatic infrared energy therapy on diabetic feet with peripheral sensory neuropathy: a randomised controlled trial

Nawfar SA, Yacob NB

Singapore Med J, 2011 Sep;52(9):669-72.
PMID: 21947144

INTRODUCTION: Peripheral diabetic neuropathy, which is a cause of increasing morbidity and mortality following foot ulcers and amputations, is a burden to health and the economy. Various adjunct treatments to improve neuropathy have been introduced into the market; one such treatment is monochromatic infrared energy (MIRE) therapy, which claimed to produce promising results. This study aimed to evaluate the effects of MIRE on diabetic feet with peripheral neuropathy.
METHODS: A randomised controlled, single-blinded study was conducted at Hospital Universiti Sains Malaysia from February 2008 to October 2008. A total of 30 feet from 24 patients were studied. Neuropathy was screened using the Michigan neuropathy scoring instrument, followed by an assessment of the current perception threshold using a neurometer at frequencies of 2,000 Hz, 250 Hz and 5 Hz. The feet were randomised to receive either daily MIRE or sham treatment for a total of 12 treatments. Each foot was then reassessed using the neurometer at six weeks and three months following treatment.
RESULTS: The data obtained was analysed using a non-parametric test to compare the pre- and post-treatment groups. No significant difference was found between the neuropathic foot of diabetic patients in both the MIRE and sham groups.
CONCLUSION: No improvement of neuropathy was observed following MIRE treatment in the neuropathic feet of diabetic patients.

Matched MeSH terms: Aged, 80 and over
Fulltext 18F-FDG positron emission tomography/computed tomography and the "underground map" appearance in imaging Horton's arteritis

Abdul Jalil N, Abdul Rahim N, Md Shalleh N, Rossetti C

Singapore Med J, 2008 Jul;49(7):e178-82.
PMID: 18695852

A majority of the clinical use of positron emission tomography (PET)-computed tomography (CT) is related to cancer management. Its application in evaluating inflammatory diseases and pyrexia of unknown origin is becoming popular. We reviewed the fluorine-18-fluorodeoxyglucose PET-CT findings of an 80-year-old woman with nonspecific clinical presentation consisting of generalised malaise, moderately high fever and weight loss. Prior CT and magnetic resonance imaging were not helpful in providing a clinical diagnosis. The diagnosis was Horton's arteritis, and the patient responded well to high-dose steroids.

Matched MeSH terms: Aged, 80 and over
Fulltext Compliance to national guidelines on the management of chronic obstructive pulmonary disease in Malaysia: a single centre experience

Azarisman SM, Hadzri HM, Fauzi RA, Fauzi AM, Faizal MP, Roslina MA, et al.

Singapore Med J, 2008 Nov;49(11):886-91; quiz 892-6.
PMID: 19037555

INTRODUCTION: Malaysia has a high rate of smoking prevalence and the figure is increasing. Although there has been many local and regional studies on the prevalence and symptomatology of chronic obstructive pulmonary disease patients, data is lacking on the degree of compliance to national management guidelines in the treatment of chronic obstructive pulmonary disease.
METHODS: 86 patients who attended the respiratory outpatient clinic of the Hospital Universiti Kebangsaan Malaysia were enrolled into a prospective, observational study.
RESULTS: 88 percent of the patients were male and the majority was ethnically Chinese (65 percent). The majority of patients were in the moderate to very severe categories, with a mean FEV1 of 0.97 +/- 0.56 L/sec and predicted mean FEV1 percentage of 43.1 +/- 21.3 percent. 58 percent of the patients were on long-acting beta-agonist, 65 percent were on inhaled steroids, and only 16 percent were on scheduled pulmonary rehabilitation.
CONCLUSION: The low uptake rate for long-acting beta-agonist and pulmonary rehabilitation could be attributed to several factors. Financial cost, the need for strict compliance to a structured rehabilitation regime, lack of significant social support and clear up-to-date guidelines are possible reasons.
Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia

Matched MeSH terms: Aged, 80 and over
Fulltext Expression of survivin and its clinicopathological correlations in invasive ductal carcinoma of the breast

Al-Joudi FS, Iskandar ZA, Hasnan J, Rusli J, Kamal Y, Imran AK, et al.

Singapore Med J, 2007 Jul;48(7):607-14.
PMID: 17609820

INTRODUCTION: Survivin is a 16.5-kDa intracellular protein that inhibits apoptosis and regulates cell division, and belongs to the inhibitors of apoptosis gene family. It appears to have an important role in regulating apoptosis at the cell cycle checkpoints. Survivin has been found to have a differential distribution in cancer compared to normal tissue, as it is over-expressed in malignant tumours.
METHODS: In addition to the demographical analysis of the disease, data from 382 women with invasive ductal carcinoma of the breast were collected from three hospitals in Northeast Malaysia, and analysed for survivin expression by immunohistochemistry.
RESULTS: Invasive ductal carcinoma of the breast was found to be the most prevalent breast cancer type. Survivin was detected in 260 (68.1 percent) study cases. In addition, significant correlations have been shown between survivin expression on one hand, and tumour size and lymph node involvement on the other hand (p-value is less than 0.05). However, no significant correlations were found with other clinicopathological factors, such as tumour histological grade, tumour side, oestrogen and progesterone receptors. Nuclear expression of survivin was detected in 16.5 percent of the study cases, cytoplasmic expression was detected in 24.1 percent, and 27.5 percent of the cases expressed survivin in both nuclear and cytoplasmic locations simultaneously. The subcellular localisation of survivin was significantly correlated (p is less than 0.001) with the lymph node involvement indicating its value in predicting the aggressiveness of tumour cells, since it increases the resistance to apoptosis and promotes cell proliferation.
CONCLUSION: This is the fi rst known report on survivin expression in cancer in West Malaysia and Southeast Asia. It emphasises the importance of the detection of survivin in breast cancer to aid in diagnosis, confirm malignancy, and to assess the disease progress and response to therapy.

Matched MeSH terms: Aged, 80 and over
Fulltext Morphometric analysis of skin microvasculature in the diabetic foot

Yusof MI, Al-Astani AD, Jaafar H, Rashid FA

Singapore Med J, 2008 Feb;49(2):100-4.
PMID: 18301834

INTRODUCTION: This study was designed to evaluate the histopathological features of skin microvasculature in patients with a diabetic foot, specifically the number of blood vessels, number of endothelial cells and endothelial thickness.
METHODS: This study involved 41 diabetic foot patients admitted to Hospital Universiti Sains Malaysia for surgical management of foot problems. Skin biopsies were taken for histological evaluation following surgical procedures, such as wound debridement or local foot amputation. The skin microvasculature features examined were the number of blood vessels, the endothelial thickness of the vessels and the cross-sectional endothelial cell count. The findings were compared with the similar parameters of non-diabetic patients (control) and analysed.
RESULTS: The mean blood vessel count (BVC), endothelial cell thickness (ECT) and endothelial cell count (ECC) for the diabetic group were 12.56 +/- 2.77, 4.81 +/- 1.5 micrometres and 7.07 +/- 1.88, respectively. The mean BVC, ECT and ECC for the non-diabetic control group were 5.25 +/- 1.98, 1.9 +/- 0.55 micrometres and 4.11 +/- 1.17, respectively. The mean BVC, ECT and ECC for the diabetic group were significantly higher than those for the non-diabetic control group.
CONCLUSION: The increased number of blood vessels to the skin and their endothelial cell number and thickness may be the contributing factors for problems related to the diabetic foot, such as tendency for skin ulceration, infection and poor wound-healing in these patients. These may also contribute to secondary changes of diabetic foot lesions, indicating failure of adequate vascularisation of the foot.

Matched MeSH terms: Aged, 80 and over
Fulltext Diabetic foot complications: a two-year review of limb amputation in a Kelantanese population

Yusof MI, Sulaiman AR, Muslim DA

Singapore Med J, 2007 Aug;48(8):729-32.
PMID: 17657379

INTRODUCTION:
Many conditions, including benign and malignant tumours, peripheral vascular diseases and open fracture grade 3C, have been successfully treated with limb sparing procedures. However, the same could not be said for treatment of limb infection, especially late stage diabetic foot complications.

METHODS:
This is a retrospective review of patients who underwent operations at our hospital from July 2003 to June 2005. All patients who underwent various types of limbs amputations were included. The cohort was divided according to the diagnosis leading to the amputation and the level of amputation. The number and levels of amputation were then compared with the various causes leading to the amputation.

RESULTS:
There were 203 patients who underwent amputation during the period of study. 135 (66.5 percent) of the patients were diabetic and amputations performed were related to diabetic foot conditions. 68 (33.5 percent) patients were not known to have diabetes mellitus. Among nondiabetic patients, 54 (26.6 percent) amputations were due to trauma, 11 (5.4 percent) were related to musculoskeletal tumours and 3 (1.5 percent) were due to peripheral vascular disease. Among diabetic patients, 23 (17 percent) patients underwent above knee amputation, 44 (33 percent) patients underwent below knee amputation, and 68 (50 percent) patients underwent local foot amputation. 80 of 135 (59.3 percent) patients, who underwent amputation due to diabetic complications, were less than 60 years old.

CONCLUSION:
Good diabetic control and detection of early diabetic foot complications will reduce the number of patients undergoing limb amputation as well as the number of amputees. Since the incidence of lower limb amputation is due mainly to poor diabetic control, it is important to protect this group of patients from a probable avoidable amputation.

Matched MeSH terms: Aged, 80 and over
Fulltext Computed tomography perfusion of ischaemic stroke patients in a rural Malaysian tertiary referral centre

Man K, Kareem AM, Ahmad Alias NA, Shuaib IL, Tharakan J, Abdullah JM, et al.

Singapore Med J, 2006 Mar;47(3):194-7.
PMID: 16518552

Computed tomography (CT) perfusion is a new method to diagnose ischaemic stroke especially in developing countries. It identifies the area and is useful to predict the size of final infarction. The aim of this study was to assess cerebral ischaemia with CT perfusion (CTP) among patients with acute ischaemic stroke in Hospital Universiti Sains Malaysia, a tertiary referral centre in a rural setting.

Matched MeSH terms: Aged, 80 and over
Fulltext Survey of postoperative pain in University Hospital Kuala Lumpur

Vijayan R, Tay KH, Tan LB, Loganathan

Singapore Med J, 1994 Oct;35(5):502-4.
PMID: 7701371

One hundred and eighty-three patients undergoing surgery were interviewed twenty-four hours following surgery to assess the quality of pain relief they received in the immediate postoperative period. Interviews were conducted using a standard questionnaire for all patients. They were asked to (1) rate the quality of pain relief they obtained on a Visual Pain Analogue Scale (VPAS-0 being no pain and 10 being the worst imaginable pain); (2) state whether they were happy and satisfied with the pain relief they received; (3) if dissatisfied, they were asked to give their reasons. 37.7% (69 patients) had moderate to severe pain--pain score greater than 6 on the VPAS. Most of these patients had undergone abdominal or major orthopaedic surgery. 32.7% (60 patients) were unhappy with their postoperative pain control. The main reasons for complaint from the patients were that analgesic injections were either not given promptly or were not given at all. The survey also highlighted the inadequate under-administration of narcotic injections in the postoperative period despite orders being written up. It showed there is an urgent need for setting up an Acute Pain Service for better postoperative pain control. An anaesthesiology based Acute Pain Service was started in October 1992.

Matched MeSH terms: Aged, 80 and over
Fulltext Effect of H2 antagonists on outcome of simple closure for perforated duodenal ulcer

Koh KB, Chang KW

Singapore Med J, 1992 Oct;33(5):472-3.
PMID: 1360708

The treatment of perforated duodenal ulcer is controversial. Since the advent of H2 antagonists, the number of ulcer operations has declined tremendously. We wanted to find out if the addition of a H2 antagonist after simple closure of a perforated duodenal ulcer would change the outcome and therefore reviewed 46 patients treated in this fashion. Our results show that this is a safe and effective way of treating patients with perforated duodenal ulcer.

Matched MeSH terms: Aged, 80 and over

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links