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  1. Spontaneous intracerebral hemorrhage in northeast Malaysian patients: a four-year study
    Muiz AJ, Abdullah J, Naing NN, Ghazaime G, Ariff AR
    Neuroepidemiology, 2003 May-Jun;22(3):184-95.
    PMID: 12711851
    The aim of this study was to compare nonsurgical versus stereotactic aspiration of intracerebral hematomas in relation to clinical aspects, computed tomographic imaging features of the brain, laboratory parameters and specific risk factors that may influence the outcome in southeast Asian Malay patients. Fifty-five of the patients with intracerebral hemorrhage (ICH) underwent stereotactic aspiration and 57 did not. Analysis was done on risk factors, locations and treatments of ICH, and the final outcomes measured by the Glasgow Outcome Scale. A total of 112 patients were evaluated. Mean age was 52 years with ages ranging from 12 to 80 years. Hypertension was seen in 60.7% of patients with ICH. The mortality rate was 25% by 3 months. 58.9% had a poor final outcome, while 41.1% had a good outcome. The selected variables were incorporated into models generated by multiple logistic regression method analysis to define the significant predictors of outcome. Significant predictors of outcome were the Glasgow Coma Scale score on admission, the duration of surgery and the total volume of the hematoma. Significant predictors of mortality were high total white blood cell differential count, low plasma protein, and high plasma lactate dehydrogenase and brain edema. The study suggests that stereotactic aspiration of patients with ICH does not offer any definite advantage over conservative treatment.
    Matched MeSH terms: Cerebral Hemorrhage/blood; Cerebral Hemorrhage/mortality; Cerebral Hemorrhage/surgery*
  2. Periventricular haemorrhage in very low birth weight Malaysian neonates
    Boo NY, Ong LC, Lye MS, Wong KP, Mastura M
    J Trop Pediatr, 1993 Aug;39(4):224-9.
    PMID: 8411316
    A prospective study was carried out to determine the incidence, clinical presentation, early outcome, and risk factors associated with periventricular haemorrhage (PVH) in 88 (84 per cent) of the 105 consecutive very low birth weight (VLBW) (< 1500 g) Malaysian neonates born in the Maternity Hospital, Kuala Lumpur. Based on the cranial ultrasound findings, PVH was detected in 86 of the 88 neonates (98 per cent, 95 per cent confidence intervals: 95 to 101). Seventeen (20 per cent) of them had grade I, 52 (61 per cent) had grade II, 7 (8 per cent) had grade III and 10 (12 per cent) had grade IV PVH. PVH was detected in all the affected neonates by the fifth day of life. Sixty-four neonates (74 per cent) were symptomatic when PVH was first detected. Shock (P < 0.01), pallor (P = 0.028), low haematocrit of less than 40 per cent (P < 0.01), convulsion (P < 0.001), and bulging of anterior fontanelle (P = 0.019) were significantly more common in the neonates with severe PVH (grades III or IV). Death occurred in 43/86 (50 per cent, 95 per cent confidence interval: 39-61 per cent) of the neonates with PVH before their first discharge from the hospital. Ventriculomegaly developed in 29/43 (67 per cent, 95 per cent confidence intervals: 54.4-81.4) of the survivors with PVH. Our study suggests that PVH is a common problem in the Malaysian VLBW neonates. To reduce the incidence and severity of this condition, prevention of preterm delivery and improvement in the basic facilities for neonatal care would help.
    Matched MeSH terms: Hemorrhage/diagnosis*; Hemorrhage/epidemiology; Hemorrhage/physiopathology
  3. Trends in selected obstetric complications from University Hospital, Kuala Lumpur, Malaysia
    Zulkifli SN, Paine LL, Greener DL, Subramaniam R
    Int J Gynaecol Obstet, 1991 May;35(1):29-36.
    PMID: 1680072
    Trends in selected pregnancy complications from 1969 to 1987 in a tertiary hospital in Malaysia are presented. Complications reviewed were abortion, ectopic pregnancy, anemia, hypertension, hyperemesis, antepartum and postpartum hemorrhage. Possible explanations for the observed trends were discussed, including the role of improved obstetric care and changes in the characteristics of the childbearing population. The data presented give some indication of maternal morbidity in the childbearing population served by this tertiary center and should lead to improvements in provision of services as well as in health data collection in the future.
    Matched MeSH terms: Hemorrhage/epidemiology; Postpartum Hemorrhage/epidemiology
  4. Fulltext Haemorrhagic lumbar synovial cyst
    Soon CK, Razak M
    Med J Malaysia, 2001 Dec;56 Suppl D:57-60.
    PMID: 14569769
    Hemorrhagic lumbar synovial cysts are not commonly reported in English literature. Post-resection recurrence of synovial cyst is unusual and therefore recurrence symptoms required repeat MRI or CT scan. We reported a case of hemorrhagic lumbar synovial cyst presented with neurological deficit that recovered initially after surgery but subsequently developed recurrent of symptoms at a higher level due to fibrous tissue.
    Matched MeSH terms: Hemorrhage/complications*; Hemorrhage/diagnosis; Hemorrhage/therapy
  5. Haemorrhage into a hydronephrotic sac
    Day LF
    Malayan Medical Journal, 1932;7:61-2.
    Matched MeSH terms: Hemorrhage
  6. Cost-utility analysis of an adjunctive recombinant activated factor VIIa for on-demand treatment of bleeding episodes in dengue haemorrhagic fever
    Naing C, Poovorawan Y, Mak JW, Aung K, Kamolratankul P
    Blood Coagul Fibrinolysis, 2015 Jun;26(4):403-7.
    PMID: 25692521 DOI: 10.1097/MBC.0000000000000280
    The present study aimed to assess the cost-utility analysis of using an adjunctive recombinant activated factor VIIa (rFVIIa) in children for controlling life-threatening bleeding in dengue haemorrhagic fever (DHF)/dengue shock syndrome (DSS). We constructed a decision-tree model, comparing a standard care and the use of an additional adjuvant rFVIIa for controlling life-threatening bleeding in children with DHF/DSS. Cost and utility benefit were estimated from the societal perspective. The outcome measure was cost per quality-adjusted life years (QALYs). Overall, treatment with adjuvant rFVIIa gained QALYs, but the total cost was higher. The incremental cost-utility ratio for the introduction of adjuvant rFVIIa was $4241.27 per additional QALY. Sensitivity analyses showed the utility value assigned for calculation of QALY was the most sensitive parameter. We concluded that despite high cost, there is a role for rFVIIa in the treatment of life-threatening bleeding in patients with DHF/DSS.
    Matched MeSH terms: Hemorrhage/complications; Hemorrhage/drug therapy*; Hemorrhage/economics*
  7. Macular haemorrhage in adult acute leukaemia patients at presentation and the risk of subsequent intracranial haemorrhage
    Jackson N, Reddy SC, Harun MH, Quah SH, Low HC
    Br J Haematol, 1997 Jul;98(1):204-9.
    PMID: 9233585
    Retinal changes are common in adult acute leukaemia patients at presentation, but whether they correlate with the risk of subsequent intracranial haemorrhage is unknown. A 4-year study has been carried out in 82 newly-diagnosed acute leukaemia patients, aged 12-77 years, who were studied prospectively for the presence of intra-retinal haemorrhages (IRH), white-centred haemorrhages (WCH), cotton-wool spots (CWS) and macular haemorrhages (MH). Groups with and without these features were compared for their risk of intra-cranial haemorrhage (ICH) within the first 30 d following diagnosis. There was no association between the incidence of ICH and the presence of IRH, WCH or CWS. However, 6/13 of those with MH developed ICH, compared to 6/69 of those without MH (relative risk 5.0, CI 95% [2.03-12.33], P=0.003). The only other identifiable risk factor for ICH was the M3 subtype of AML, but if the four cases of M3-AML were discounted from analysis, MH remained a highly significant risk factor for ICH. Patients with MH should be monitored intensively for the development of ICH, and receive priority in the allocation of platelets where these are in short supply.
    Matched MeSH terms: Cerebral Hemorrhage/etiology*; Retinal Hemorrhage/etiology*
  8. Fulltext The effects of Carica papaya Linn. latex on the healing of burn wounds in rats
    Ahmad Nazrun Shuid, Mohd Syukri Anwar, Ahmad Asmadi Yusof
    Jurnal Sains Kesihatan Malaysia, 2005;3(2):39-47.
    MyJurnal
    This study was carried out to compare the rate of burn wound healing with the applications of the latex of Carica papaya Linn. (papaya) or of silver sulfadiazine cream (SSD). Partial and full thickness burn wound (2 cm x 2 cm) was induced on the dorsal part of anaesthetized rats by using heated metal plates. The rats were divided into three groups, i.e. untreated group and groups treated daily with SSD and papaya latex, respectively. A digital camera was used to take photographs of the burn wounds daily to monitor their healing. It was found that there was no significant difference in the healing time of papaya latex treated group compared to the SSD treated group. Papaya latex contained digestive enzymes which might clean burn wounds but might also cause wound bleeding in a few rats of the papaya latex group.
    Matched MeSH terms: Hemorrhage
  9. Fulltext An Unusual Presentation of a Thyroid Malignancy: A Case Report
    Irfan, M., Baharuddin, A., Ananda Dorai, A.
    International Medical Journal Malaysia, 2010;9(1):55-57.
    MyJurnal
    Patient with thyroid mass rarely presents in emergency situation. It is because the nature of the mass is that it usually increases slowly in size. Thus, any surgical intervention can be planned electively. The most common condition that necessitates urgent intervention, is upper airway compromise due to sudden rapid increase in size of the swelling. This can be due to intralesional bleeding or superimposed infection on the enlarged gland. We report a case of urgent completion thyroidectomy performed to a patient with fungating recurrent papillary carcinoma who present with bleeding from the mass externally.
    Matched MeSH terms: Hemorrhage
  10. Fulltext Dengue fever presenting as bilateral dengue maculopathy
    Umi Kalthum, M.N.
    Medicine & Health, 2012;7(1):57-61.
    MyJurnal
    Dengue fever is a common pyrexial-viral infection in the Asian region and the incidence is increasing yearly. There are various ocular manifestations of dengue fever such as maculopathy, retinal hemorrhages, retinal lesions and vasculitis. Reduction in visual acuity and other visual disturbances such as metamorphopsia is the most common presentation of dengue-associated maculopathy. We report an interesting case of a young lady with bilateral maculopathy secondary to dengue fever who was managed conservatively with dramatic visual improvements. This case highlights the possibility of bilateral and simultaneous ocular involvements in patients infected with dengue fever. Both ophthalmologists and physicians need to be aware of ocular complications following dengue fever and advice patients regarding the symptoms.
    Matched MeSH terms: Retinal Hemorrhage
  11. Fulltext Mimics and diagnostic pitfalls of intracranial lesions in conventional MRI: Clues on advanced MRI
    Peter, Alan Basil, Norlisah Ramli, Kartini Rahmat, Faizatul Izza Rozalli, Che Ahmad Azlan
    Neurology Asia, 2015;20(2):161-165.
    MyJurnal
    Objective: To delineate and differentiate between late subacute hemorrhage and intracranial lipomas in clinically available conventional and advanced MR sequences. Methods: Two cases of late subacute hemorrhage and two cases of intracranial lipoma were reviewed with CT scans and 3.0T scanner MRI. The sequences evaluated in MRI were T1-weighted (T1W) fast spin echo (FSE), T2-weighted (T2W) FSE, gradient echo T2*-weighted (GRE T2*W) images, diffusion weighted (DWI), apparent diffusion coefficient (ADC) and multivoxel spectroscopy. Results: Late subacute hemorrhage and intracranial lipoma have similar imaging features on T1W, T2W FSE with blooming artefact at the margins on GRE T2*W. However on GRE T2*W sequence, the central area of lipoma demonstrates low signal; while hemorrhage demonstrates high signal. In DWI, late subacute hemorrhage shows hyperintensity; while in lipoma there is loss of signal.
    Conclusion: Awareness of the potential pitfalls in standard sequence are important, as these entities appear to have similar T1W/ T2W characteristic with blooming artefact on T2*W. Knowing the distinctive central signal intensity pattern on GRE T2W* and DWI is therefore essential to differentiate between these lesions as there are differences to their clinical management.
    Matched MeSH terms: Hemorrhage
  12. Fulltext Sudden visual loss in acute leukaemia
    Tengku Kamalden, T.A., Nurliza, K., Haris, A.R.
    JUMMEC, 2008;11(1):30-32.
    MyJurnal
    The presenting signs of acute leukaemia occur as a result of bone marrow failure and organ infiltration. Increased bleeding tendencies are seen on the skin, gums and mucosal lining. Bleeding in the posterior segment of the eye, namely the retina and vitreous, may occur, but do not usually cause any visual disturbances. This case demonstrates visual loss as a result of premacular subhyaloid haemorrhage in acute leukaemia.
    Matched MeSH terms: Retinal Hemorrhage
  13. Upper gastrointestinal haemorrhage in severe dengue: To scope or not to scope?
    Lim CH, Benjamin NH, Kan FK
    Med J Malaysia, 2017 02;72(1):55-57.
    PMID: 28255142 MyJurnal
    Upper gastrointestinal haemorrhage (UGIH) in severe dengue represents a clinical dilemma in term of management. The recommended treatment in dengue with UGIH involves blood product transfusion support and proton pump inhibitor (PPI) infusion. Despite being the mainstay of treatment in non-dengue UGIH, the role of endoscopic haemostatic intervention in severe dengue remains controversial. In the present report, we present a case of severe dengue complicated with upper gastrointestinal haemorrhage successfully underwent early therapeutic endoscopic intervention in a district hospital.
    Matched MeSH terms: Gastrointestinal Hemorrhage
  14. Case series of haemothorax secondary to avulsed bullae vessel
    Low QJ, Hatta Z, Cheo SW, Syed RSH, Goh KS
    Med J Malaysia, 2019 Oct;74(5):431-432.
    PMID: 31649221
    Haemothorax refer to the bleeding in the pleural space. It is commonly due to iatrogenic, blunt or penetrating chest trauma. Non-traumatic haemothorax is a rare entity that can potentially lead to life threatening complications. The initial management of both traumatic and non-traumatic haemothorax includes resuscitation and stabilisation of the patient. We would like to present two cases of non-traumatic haemothorax secondary to an avulsed bullae vessel.
    Matched MeSH terms: Hemorrhage
  15. Medical therapy for bleeding peptic ulcer
    Ranjeev P, Goh KL
    JUMMEC, 2000;5:67-72.
    The majority of patients with upper gastrointestinal bleeding due to peptic ulcers stop bleeding spontaneously. The remainder of patients who have persistent or recurrent bleeding will require surgicaJ or endoscopic intervention. Medical therapy provides an attractive alternative to these two treatment options. The advent of H2 antagonists in the mid 19705 revolutionized the treatment of peptic ulcer disease as it provided good ulcer healing with a treatm.ent course of 6-8 weeks. A more potent acid suppressingdassof drugs: the proton-pump inhibitors (PPJ's) were introduced in the late 19805 and provided even better and faster ulcer healing. It was natural that the acid suppressing drugs were also used for the treatment of ulcer bleeding. Intravenous H2 antagonist and more recently intravenous PPJ's have routinely been prescribed in many hospitals as soon itS a bleeding patient is admitted. Critical evaluation of the literature shows, however, that H2 antagonists are no more effective than placebo in stopping ulcer bleeding. The prJ's, on the other hand, have been shown in several clinical studies to have a beneficial effect. The action of acid suppression in stopping ulcer bleeding is believed to be due to its effect in the stabilization of an ulcer clot by providing a high pH milieu and to commence the process of ulcer healing. KEYWORDS: Upper gastrointestinal bleed(UGIB), proton pump inhibitors(PPls), H2 antagonists
    Matched MeSH terms: Gastrointestinal Hemorrhage
  16. Neuroprotection by trans-resveratrol against collagenase-induced neurological and neurobehavioural deficits in rats involves adenosine A1 receptors
    Abd Aziz NAW, Iezhitsa I, Agarwal R, Abdul Kadir RF, Abd Latiff A, Ismail NM
    Neurol Res, 2020 Mar;42(3):189-208.
    PMID: 32013788 DOI: 10.1080/01616412.2020.1716470
    Objective:Trans-resveratrol has been shown to have neuroprotective effects and could be a promising therapeutic agent in the treatment of intracerebral haemorrhage (ICH). This study aimed to investigate the involvement of the adenosine A1 receptor (A1R) in trans-resveratrol-induced neuroprotection in rats with collagenase-induced ICH.Methods: Sixty male Sprague-Dawley rats weighing 330-380 g were randomly divided into five groups (n = 12): (i) control, (ii) sham-operated rats, (iii) ICH rats pretreated with vehicle (0.1% DMSO saline, i.c.v.), (iv) ICH rats pretreated with trans-resveratrol (0.9 µg, i.c.v.) and (v) ICH rats pretreated with trans-resveratrol (0.9 µg) and the A1R antagonist, DPCPX (2.5 µg, i.c.v.). Thirty minutes after pretreatment, ICH was induced by intrastriatal injection of collagenase (0.04 U). Forty-eight hours after ICH, the rats were assessed using a variety of neurobehavioural tests. Subsequently, rats were sacrificed and brains were subjected to gross morphological examination of the haematoma area and histological examination of the damaged area.Results: Severe neurobehavioural deficits and haematoma with diffuse oedema were observed after intrastriatal collagenase injection. Pretreatment with trans-resveratrol partially restored general locomotor activity, muscle strength and coordination, which was accompanied with reduction of haematoma volume by 73.22% (P < 0.05) and damaged area by 60.77% (P < 0.05) in comparison to the vehicle-pretreated ICH group. The trans-resveratrol-induced improvement in neurobehavioural outcomes and morphological features of brain tissues was inhibited by DPCPX pretreatment.Conclusion: This study demonstrates that the A1R activation is possibly the mechanism underlying the trans-resveratrol-induced neurological and neurobehavioural protection in rats with ICH.
    Matched MeSH terms: Cerebral Hemorrhage/chemically induced; Cerebral Hemorrhage/pathology*; Cerebral Hemorrhage/psychology*
  17. Fulltext Outcomes in Antiplatelet-Associated Intracerebral Hemorrhage in the TICH-2 Randomized Controlled Trial
    Law ZK, Desborough M, Roberts I, Al-Shahi Salman R, England TJ, Werring DJ, et al.
    J Am Heart Assoc, 2021 02;10(5):e019130.
    PMID: 33586453 DOI: 10.1161/JAHA.120.019130
    Background Antiplatelet therapy increases the risk of hematoma expansion in intracerebral hemorrhage (ICH) while the effect on functional outcome is uncertain. Methods and Results This is an exploratory analysis of the TICH-2 (Tranexamic Acid in Intracerebral Hemorrhage-2) double-blind, randomized, placebo-controlled trial, which studied the efficacy of tranexamic acid in patients with spontaneous ICH within 8 hours of onset. Multivariable logistic regression and ordinal regression were performed to explore the relationship between pre-ICH antiplatelet therapy, and 24-hour hematoma expansion and day 90 modified Rankin Scale score, as well as the effect of tranexamic acid. Of 2325 patients, 611 (26.3%) had pre-ICH antiplatelet therapy. They were older (mean age, 75.7 versus 66.5 years), more likely to have ischemic heart disease (25.4% versus 2.7%), ischemic stroke (36.2% versus 6.3%), intraventricular hemorrhage (40.2% versus 27.5%), and larger baseline hematoma volume (mean, 28.1 versus 22.6 mL) than the no-antiplatelet group. Pre-ICH antiplatelet therapy was associated with a significantly increased risk of hematoma expansion (adjusted odds ratio [OR], 1.28; 95% CI, 1.01-1.63), a shift toward unfavorable outcome in modified Rankin Scale (adjusted common OR, 1.58; 95% CI, 1.32-1.91) and a higher risk of death at day 90 (adjusted OR, 1.63; 95% CI, 1.25-2.11). Tranexamic acid reduced the risk of hematoma expansion in the overall patients with ICH (adjusted OR, 0.76; 95% CI, 0.62-0.93) and antiplatelet subgroup (adjusted OR, 0.61; 95% CI, 0.41-0.91) with no significant interaction between pre-ICH antiplatelet therapy and tranexamic acid (P interaction=0.248). Conclusions Antiplatelet therapy is independently associated with hematoma expansion and unfavorable functional outcome. Tranexamic acid reduced hematoma expansion regardless of prior antiplatelet therapy use. Registration URL: https://www.isrctn.com; Unique identifier: ISRCTN93732214.
    Matched MeSH terms: Cerebral Hemorrhage/chemically induced*; Cerebral Hemorrhage/diagnosis; Cerebral Hemorrhage/physiopathology
  18. Retained Endoscope: An Unexpected but Serious Complication of Hemospray®
    Yii RSL, Chuah KH, Poh KS, Lau PC, Ng KL, Ho SH, et al.
    Dig Dis Sci, 2022 01;67(1):344-347.
    PMID: 33491164 DOI: 10.1007/s10620-021-06835-4
    Matched MeSH terms: Gastrointestinal Hemorrhage/diagnosis; Gastrointestinal Hemorrhage/etiology; Gastrointestinal Hemorrhage/therapy*
  19. Evaluation of the predictive performance of bleeding risk scores in patients with non-valvular atrial fibrillation on oral anticoagulants
    Beshir SA, Aziz Z, Yap LB, Chee KH, Lo YL
    J Clin Pharm Ther, 2018 Apr;43(2):209-219.
    PMID: 29030869 DOI: 10.1111/jcpt.12634
    WHAT IS KNOWN AND OBJECTIVE: Bleeding risk scores (BRSs) aid in the assessment of oral anticoagulant-related bleeding risk in patients with atrial fibrillation. Ideally, the applicability of a BRS needs to be assessed, prior to its routine use in a population other than the original derivation cohort. Therefore, we evaluated the performance of 6 established BRSs to predict major or clinically relevant bleeding (CRB) events associated with the use of oral anticoagulant (OAC) among Malaysian patients.

    METHODS: The pharmacy supply database and the medical records of patients with non-valvular atrial fibrillation (NVAF) receiving warfarin, dabigatran or rivaroxaban at two tertiary hospitals were reviewed. Patients who experienced an OAC-associated major or CRB event within 12 months of follow-up, or who have received OAC therapy for at least 1 year, were identified. The BRSs were fitted separately into patient data. The discrimination and the calibration of these BRSs as well as the factors associated with bleeding events were then assessed.

    RESULTS: A total of 1017 patients with at least 1-year follow-up period, or those who developed a bleeding event within 1 year of OAC use, were recruited. Of which, 23 patients experienced a first major bleeding event, whereas 76 patients, a first CRB event. Multivariate logistic regression results show that age of 75 or older, prior bleeding and male gender are associated with major bleeding events. On the other hand, prior gastrointestinal bleeding, a haematocrit value of less than 30% and renal impairment are independent predictors of CRB events. All the BRSs show a satisfactory calibration for major and CRB events. Among these BRSs, only HEMORR2 HAGES (C-statistic = 0.71, 95% CI 0.60-0.82, P 

    Matched MeSH terms: Hemorrhage/chemically induced*; Gastrointestinal Hemorrhage/chemically induced
  20. Addressing unmet needs for patients with previous upper gastrointestinal bleed requiring concomitant aspirin and non-steroidal anti-inflammatory drugs
    Jayaraman T, Wong MS, Mustaffa N, Lee YY
    J R Coll Physicians Edinb, 2017 12;47(4):356-358.
    PMID: 29537408 DOI: 10.4997/JRCPE.2017.411
    Matched MeSH terms: Gastrointestinal Hemorrhage
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