MyMedR

Caesarean hysterectomy--a review of 21 cases in the University Hospital, Kuala Lumpur

Rachagan SP, Sivanesaratnam V

Eur J Obstet Gynecol Reprod Biol, 1984 Jan;16(5):321-6.

Caesarean hysterectomy is a useful surgical procedure. However, the increased blood supply to the pelvis during pregnancy, distortion of the anatomy caused by the enlarged uterus, fragility of oedematous pelvic tissues and adhesions from prior caesarean sections predispose to poor haemostasis and urinary tract injuries. In this series all the cases were done as an emergency procedure and, despite the multiple obstetric complications, there was no maternal mortality and the incidence of post-operative morbidity was low.

Matched MeSH terms: Retrospective Studies

Fulltext Pleural effusion in 100 Malaysian patients

Ngoh HL

Med J Malaysia, 1991 Dec;46(4):301-8.

PMID: 1840436

In a retrospective study of 100 patients with pleural effusion the final diagnosis was tuberculosis in 49, malignancy in 43, malignancy with tuberculosis, bacterial infection, hydrothorax with cirrhosis, reaction to pneumothorax in one each, and unknown in 4. Most of the effusions analysed were exudates (94%). Pleural biopsy was diagnostic in 46% of tuberculous effusions (13/28) and 67% of malignant effusions (20/30). Tuberculosis accounted for 87% of cases in patients aged 40 years and under. In this age group, patients with exudative pleural effusion and a positive tuberculin test are likely to have tuberculosis and early therapeutic trial is justified.

Matched MeSH terms: Retrospective Studies

Rupture of the pregnant uterus--a 21-year review

Rachagan SP, Raman S, Balasundram G, Balakrishnan S

Aust N Z J Obstet Gynaecol, 1991 Feb;31(1):37-40.

PMID: 1872771

Uterine rupture is still a common problem in developing countries although even here the incidence varies from urban to rural settings. This article is a review of uterine rupture in an urban referral hospital in Malaysia. It examines aetiology, clinical presentation, complications and management of the problem. Meticulous screening of patients together with optimal antenatal and intrapartum care will markedly reduce the incidence of uterine rupture. Early diagnosis and prompt treatment will further help reduce morbidity and mortality to both mother and fetus.

Matched MeSH terms: Retrospective Studies

Pelvic lymph node metastases in early invasive carcinoma of the cervix--histopathological 'risk' factors

Jayalakshmi P, Sivanesarathnam V

Aust N Z J Obstet Gynaecol, 1991 Feb;31(1):87-9.

PMID: 1872785

Histopathological features in 89 cases of Stage 1B and early 2A invasive carcinoma of the cervix who underwent Wertheim radical hysterectomy and pelvic lymphadenectomy were studied. Depth of tumour invasion and lymphatic/vascular space permeation by tumour cells were significantly associated with lymph node metastases. The other features such as tumour type, and stromal leucocytic reaction showed no significant relationship to the presence of lymph node metastases.

Matched MeSH terms: Retrospective Studies

Fulltext Hyperthyroid graves disease--a 5 year retrospective study

Tan TT, Ng ML, Wu LL, Khalid BA

Med J Malaysia, 1989 Sep;44(3):224-30.

PMID: 2626137

The clinical, biochemical and immunological features of 180 patients with hyperthyroid Graves' disease managed at the Universiti Kebangsaan Malaysia (UKM) Endocrine Clinic from 1983 to 1987 were examined. The prevalence of the disease is highest in Chinese and lowest in Indians. The female: male ratio is 2.8:1. Hypokalaemic periodic paralysis and hypercalcaemia were present in 5.0% and 1.7% of the cases respectively. Pretibial myxoedema was extremely rare. Thyrotropin - binding inhibitory immunoglobulins, anti-thyroglobulin and anti-microsome antibodies were positive in 61.5%, 25.8% and 42.3% of the patients respectively. A eumetabolic state could be achieved in the majority of patients with antithyroid drugs alone. Definitive therapy with subtotal thyroidectomy or radioiodine were needed in 31.3% of cases.

Matched MeSH terms: Retrospective Studies

Childhood neuroblastoma in the University Hospital, Kuala Lumpur: a study into features of prognostic value

Looi LM, Lin HP, Cherian R, Sinniah D

Malays J Pathol, 1986 Aug;8:49-56.

PMID: 3682944

Matched MeSH terms: Retrospective Studies

Fulltext The bacteriology of perforated appendix

Lim VKE, Hussin Z, Abdul Wahab Y

Med J Malaysia, 1983 Dec;38(4):275-8.

PMID: 6599982

Perforated appendix is a serious surgical condition that carries a high morbidity. Antibiotic treatment is often started before the availability of bacteriological reports. The choice of antibiotics would depend on the bacteriology associated with perforated appendix. In a retrospective survey of the bacteriology of peritoneal pus obtained from cases of perforated appendix at the General Hospital, Kuala Lumpur, E. coli was found to be the most commonly encountered organism. This was followed in order of decreasing frequency by streptococci, Bacteroides species, Klebsiella-Enterobacter group and Pseudomonas aeruginosa. From the results of the antibiotic sensitivities an antibiotic regimen comprising of a combination of gentamicin, metronidazole and penicillin is recommended as appropriate chemotherapy in perforated appendix.

Matched MeSH terms: Retrospective Studies

Fulltext Transient hypothyroidism following I131 treatment for thyrotoxicosis

Zaini A, Ngan A, Paramsothy M, Khoo BH, Ch'ng SL

Med J Malaysia, 1983 Dec;38(4):331-3.

PMID: 6599994

Matched MeSH terms: Retrospective Studies

Fulltext Prostate biopsies--a retrospective review from the University Malaya Medical Center

Dublin N

Med J Malaysia, 2003 Dec;58(5):673-7.

PMID: 15190652

Prostate cancer is not common in south-east asia and in particular there are only scarce reports on the characteristics of Malaysian men with prostate cancer. A retrospective study where all prostate specimens sent to the pathology department during the period 1st January 1996 to 30th June 1998 were reviewed. A total of 131 prostate specimens were reviewed and these consisted of prostatectomy specimens, transurethral resection specimens and trucut biopsy specimens. Only 114 patients' case notes were evaluated. Data reviewed were age, race, presenting symptoms, clinical findings and prostate-specific antigen (PSA) level. Overall incidence of carcinoma of the prostate was 19.0%. The incidence of carcinoma of the prostate with serum prostate-specific antigen (PSA) of 4.1 to 20.0 ng/ml was only 10% and 60.5% of patients had evidence of subclinical histological prostatitis. The mean age of men with carcinoma of the prostate was 71.3 years and there was no differences in the incidence of carcinoma of the prostate among the 3 major ethnic groups (Malays, Chinese and Indian). About three-quarter of the patients with carcinoma of the prostate presented with lower urinary tract symptoms, a third had haematuria and about a tenth of patients presented with urinary retention. The majority of patients presented with metastatic disease (66.7%) with a mean PSA of 1476.8 ng/ml. A significant proportion of men with prostatic diseases attending the University of Malaya Medical Center had prostate cancer (19.0%). A small proportion of men with serum PSA in the range of 4.1 to 20.0 ng/ml had prostate cancer and this is thought to be due to the background histological prostatitis. The majority of patients presented late.

Matched MeSH terms: Retrospective Studies

Fulltext Epidemiology of prostate cancer in United Arab Emirates

Ghafoor M, Schuyten R, Bener A

Med J Malaysia, 2003 Dec;58(5):712-6.

PMID: 15190657

To evaluate the magnitude of prostate cancer in the United Arab Emirates (UAE).

Matched MeSH terms: Retrospective Studies

Fulltext Survival of patients surgically treated for lung cancer

Hooi LN, Hamzah KM, Jahizah H

Med J Malaysia, 2003 Oct;58(4):490-8.

PMID: 15190623

A study was done on survival of patients surgically treated for lung cancer from 1995-2001. The average operative rate for 852 patients was 4.8%. In 67 surgically treated patients (54M, 13F), the commonest histological type was squamous cell carcinoma (52.2%) followed by adenocarcinoma (26.9%). The surgical-pathological stage was stage I in 52.2%. Postoperatively, five-year survival was 29%, with a median survival of 27 months. Completeness of resection was the foremost determinant of survival outcome and stage higher than stage I was an adverse prognostic factor. These results indicate that the current outlook for lung cancer patients remains poor.

Study site: Hospital Pulau Pinang

Matched MeSH terms: Retrospective Studies

Fulltext Clinical presentation of patients with nasopharyngeal carcinoma

Suzina SAH, Hamzah M

Med J Malaysia, 2003 Oct;58(4):539-45.

PMID: 15190630

The poor prognosis for patients with nasopharyngeal carcinoma is principally due to its advanced stage at the time of diagnosis. The symptoms and clinical findings at presentation of 56 patients with confirmed nasopharyngeal carcinoma is described and analysed. Recognising the common modes of presentation is essential to diagnose the disease at an early stage.

Matched MeSH terms: Retrospective Studies

Fulltext An audit of upper gastrointestinal bleeding at Seremban Hospital

Lim TM, Lu PY, Meheshinder S, Selvindoss P, Balasingh D, Ramesh J, et al.

Med J Malaysia, 2003 Oct;58(4):522-5.

PMID: 15190627

We retrospectively analyzed all patients presenting with upper gastrointestinal bleeding to Seremban Hospital over a one-year period. A quarter of the oesophagogastro-duodenoscopies (OGD) performed were performed as emergency for upper gastrointestinal tract bleeding. Gastric ulcers and duodenal ulcers were the two most common findings. Our results suggest that there is a male preponderance of 2:1, the Chinese were more likely to be affected and the elderly (> 60 years) were at highest risk.

Matched MeSH terms: Retrospective Studies

Spectrum of dentofacial deformities: a retrospective survey

Ong MA

Ann Acad Med Singap, 2004 Mar;33(2):239-42.

PMID: 15098641

INTRODUCTION: This retrospective study investigates the spectrum of dentofacial deformities, demographic profile, management and surgical outcomes of orthognathic patients treated in the University Hospital in Malaysia.

MATERIALS AND METHODS: Over a period of 10 years (1989 to 1999), 34 patients with dentofacial deformities who had orthognathic surgery were reviewed; patients with cleft lip and palate or syndromes were excluded.

RESULTS: The mean age (range, 17 to 35 years) of the patients was 24.3 years and the ratio of female to male was 2.4:1. The predominant ethnic group was Chinese, with females (47.1%) forming the largest group. The main reason for seeking surgery was aesthetic improvement (41%). The majority of the patients had skeletal class III pattern (91%) and bilateral sagittal split osteotomy was the most common surgery done (82%). Postoperative complications were mainly paraesthesia/numbness (56%) and infection (15%). In long-term review, 2 (6%) patients had persistent numbness of the inferior alveolar nerve.

CONCLUSION: The findings suggest that the majority of the patients are young adult female students with skeletal class III pattern and treated for mandibular prognathism. The complication of persistent numbness and higher rate of postoperative infection indicate that longterm reviews and good antibiotic prophylaxis/therapy are necessary.

Matched MeSH terms: Retrospective Studies

Clinical course and determination of brainstem death in a children's hospital

Goh AY, Mok Q

Acta Paediatr, 2004 Jan;93(1):47-52.

PMID: 14989439

AIM: To study the aetiology and clinical course of children with brainstem death in a paediatric intensive care unit (ICU) and to determine whether current the practices that are used to declare brainstem death conform to accepted criteria.
METHODS: A retrospective review chart of all patients with brainstem death (n = 31) admitted to the paediatric ICU between January 1995 and December 1998 was drawn up.
RESULTS: Mean age of the patients was 51.9 +/- 54.5 mo with the main diagnoses being head trauma in 11 children, anoxic encephalopathy in 7, brain tumour in 5, drowning in 4, CNS haemorrhage in 3 and CNS infection in 1 child; 32.3% of the children were given pre-ICU admission cardiopulmonary resuscitation. The average time from insult to suspected brainstem death was 27 h and suspected brainstem death to confirmation was 25 h, with an average of 1.6 examinations performed. EEG was done in 14 patients, with electrocerebral silence in 8 after the first examination and in a further 5 after repeat testing. Cerebral blood-flow scans were done in 3 children and evoked potentials in 1 child.
CONCLUSIONS: Trauma remains the most common primary diagnosis leading to brainstem death. Intensivists in this large hospital for children mainly conform to accepted guidelines for determination of brainstem death although there is a wider use of ancillary tests to aid diagnosis. The study also showed a low rate of < 10% of organ procurement for transplantation.

Study site: Paediatric ICU, Great Ormond Street Hospital, London, United Kingdom

Matched MeSH terms: Retrospective Studies

Fulltext Gastrointestinal Cytomegalovirus infection in non-human immunodeficiency virus infected patients

Ng KL, Ho J, Ng HS, Luman W

Med J Malaysia, 2003 Aug;58(3):337-44.

PMID: 14750372

This is a retrospective study of fourteen patients who had proven Cytomegalovirus (CMV) infection of the gastrointestinal tract with no Human Immunodeficiency virus infection. The median age was 60.5 (Range 28 to 81) years. Eight patients were below (Group 1) and six above sixty five years old (Group 2). Areas of gastro-intestinal involvement were: oesophagus (2), stomach (1), colon (10) and multiple sites (1). Seven patients from Group 1 had received immunosuppressive therapy at the time of presentation and one had diabetes mellitus. We found a high prevalence of co-morbidities such as chronic renal failure and diabetes mellitus in Group 2. At median follow up of 13.9 months, there was a mortality rate of 50%. Only four patients were treated with ganciclovir. Our study concludes that the gastrointestinal CMV diseases in young patients were associated with immunosuppression whereas the older patients had chronic renal failure or diabetes.

Matched MeSH terms: Retrospective Studies

Tuberculosis of the spine-the Sabah experience. Epidemiology, treatment and results

Dharmalingam M

Tuberculosis (Edinb), 2004;84(1-2):24-8.

PMID: 14670343 DOI: 10.1016/j.tube.2003.08.008

A retrospective review of 33 patients with tuberculosis of the spine from January 2000 to April 2002 revealed that the mean age was 36.5 and peak incidence is in the second decade of life (27.3%). There were 24 males and 9 females. The majority of the lesions involved the thoracic spine (30.3%), followed by the lumbar spine (27.2%). Skip lesions was seen in 12.1% of cases. The erythrocyte sedimentation rate was normal in 9.1% of patients. Neurological involvement was seen in 51.5% of patients. Concomitant tuberculosis of the lung was 66.6%. The radical surgical debridement and grafting rate was 39.3%. The preferred surgical procedure was that of radical anterior debridement and fusion supplemented by anterior or posterior instrumentation if needed. Anti-tuberculous chemotherapy remained the mainstay of treatment. Surgery gives faster relief of pain and neurological recovery but is a major undertaking, and thus selection of patients is vital to avoid morbidity and mortality.

Matched MeSH terms: Retrospective Studies

Epidemiology of tuberculosis and leprosy, Sabah, Malaysia

Dony JF, Ahmad J, Yap KT

Tuberculosis (Edinb), 2004;84(1-2):8-18.

PMID: 14670341 DOI: 10.1016/j.tube.2003.08.002

The objectives in this epidemiology review are to measure and report the extent of morbidity and mortality due to tuberculosis (TB), the proportion of new sputum smear positive cases in districts and the status of cohort analysis as of 1999. As for leprosy, the main objective is to determine morbidity and the treatment outcomes of Multiple Drug Therapy (MDT). Based on the results obtained, a comprehensive action plan for prevention, control and monitoring of tuberculosis and leprosy cases and patients is being produced and implemented throughout the state. The analysis concentrated on patients diagnosed at all out-patient units and admitted in all of the state's hospitals. The patient particulars were recorded using a standardized format based on TB and Leprosy Health Management Information System (TB HMIS). TB was the second highest by notification of communicable diseases in Malaysia in 2001. 29% or about one-third of the national TB cases are from Sabah. However, it has been noted that there was an average decline of 2.6% in annual notification since 10 years ago to date. There was also a reduction of 11.4% in 2001 as compared to annual notification in 2000. Immigrants contribute more than 24% in detection of new cases since 1990. Treatment success rate in term of completion of treatment to date is 82%. Mortality rate has steadily declined from 14 deaths to 7 deaths per 100,000 population. Leprosy in Sabah also contributes to 30% of the yearly total caseload of Malaysia and has the highest notification rate of 2 per every 100,000 population as compared to other states. The average registered leprosy cases over the past 5 years are 239 cases and the prevalence rate is 0.7/10,000 population. The state has successfully achieved its goal to decrease leprosy as per the World Health Organization (WHO) goal of yearly overall prevalence rate of less than 1 case for every 10,000 population. However, the districts of Kudat, Tawau, Lahad Datu, Kota Kinabalu and Semporna are still within the prevalence rate of more than one per 10,000 population. This review highlights some interesting findings which can be incorporated into the State and Districts action plans and strategies. It is also noted that in order to translate National Plans and Strategies into effective action at the community level, health workers need relevant up-to-date knowledge of the pattern of health and disease, and of their determinants, in each district. The Sabah Health Department continues to organize and support programs related to management and control of tuberculosis and leprosy to progressively reduce the incidence of these diseases in the community by breaking the chain of transmission of Mycobacterium tuberculosis and M. leprae, respectively.
Study site: outpatient clinics, inpatients, hospitals, Sabah, Malaysia

Matched MeSH terms: Retrospective Studies

Fulltext Outcome of meniscus surgery at University Malaya Medical Centre

Vinayaga P, Amalourde A, Tay YG, Chan KY

Med J Malaysia, 2001 Dec;56 Suppl D:18-23.

PMID: 14569761 MyJurnal

Between January 1994 to December 1998, 133 patients had a meniscal surgery at University Malaya Medical Centre. Fifty-four patients were assessed and scored with the Lysholm and Tegner scoring system. Twenty-nine patients had partial meniscectomies and 25 had meniscus repair. The outcome was successful in 80% with meniscal repair and 51.7% with partial meniscectomy. The outcome of meniscal repair in this study is comparable to other reported series. However, the failure rate for partial meniscectomy was high.

Matched MeSH terms: Retrospective Studies

Fulltext Crossed-pin versus lateral-pin fixation in pediatric supracondylar fractures

Shamsuddin SA, Penafort R, Sharaf I

Med J Malaysia, 2001 Dec;56 Suppl D:38-44.

PMID: 14569765 MyJurnal

A retrospective study was done on 56 patients treated with percutaneous pinning of displaced supracondylar fractures of the humerus in the Paediatrics Institute of Hospital Kuala Lumpur between November 1999 and October 2000, to ascertain whether there is any significance clinically in the stability of a crossed pinning medial compared with lateral pinning method. There was equal number of patients in each group (28 patients). The radiographs were evaluated for change in Baumann's angle and Lateral Humero-capitellar angle from immediate post-op until the last follow-up. The changes in the angles did not reveal any statistically significant difference in the ability to maintain reduction of the fractures. There were 3 instances of iatrogenic ulnar nerve injury in the crossed pinning group; the lateral pinning group had 1 case each of anterior interosseous nerve and radial nerve injury post operatively. No vascular injury was noted. Two cases of superficial pin tract infection were present in each group. The lateral percutaneous pinning technique of displaced supracondylar fractures of the humerus therefore offers a viable alternative to the crossed pinning group as it offers the same stability without the incipient risk of iatrogenic ulnar nerve injury.

Matched MeSH terms: Retrospective Studies

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