Displaying publications 1641 - 1660 of 11223 in total

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  1. Ismail Y, Loo CS, Zahary MK
    Singapore Med J, 1994 Apr;35(2):171-2.
    PMID: 7939814
    We reviewed 116 chest radiographs done in 70 adult asthmatic patients who were admitted to the Hospital Universiti Sains Malaysia from January to December 1989. The chest radiographs were abnormal in 23% of cases. Twelve percent showed hyperinflation and 7% had pneumonia. Eight patients diagnosed clinically to have pneumonia had normal chest radiographs. Seven patients had radiographic findings of conditions which were unsuspected clinically. These included two cases of pneumonia, one case each of fibrosing alveolitis, pneumothorax, pneumomediastinum, mitral stenosis with left ventricular failure and right pleural effusion. In conclusion, we found that significant chest radiograph abnormalities in adult patients admitted for asthma were uncommon although chest radiographs were helpful in detecting complications or coincidental conditions. Chest radiograph is therefore an important investigation in adult asthmatic patients who are admitted. However, considering the cost and the risk of radiation, it should be done only in selective cases rather than as a routine procedure.
    Study site: Hospital Universiti Sains Malaysia, Kelantan, Malaysia
    Matched MeSH terms: Middle Aged
  2. Jalleh RD, Kuppusamy I, Parameswary V, Yeow CS
    Singapore Med J, 1993 Feb;34(1):55-7.
    PMID: 8266131
    We report our experience on the use of fibreoptic bronchoscopy in the diagnosis of pulmonary tuberculosis. The case records of 1,274 patients who underwent fibreoptic bronchoscopy at the National Tuberculosis Centre, Kuala Lumpur, Malaysia during a three-year period were reviewed. In 120 of them the final diagnosis was tuberculosis. Bronchoscopy confirmed the diagnosis in 37 patients (30.8%). This was achieved by bronchial aspiration for culture in 26 patients (70.3%) and bronchial biopsy for histopathology in 11 patients (29.7%). It was the exclusive method of confirmation in 16 patients (13.3%). Sputum culture was positive in 62 patients (51.7%) including 41 patients (34.2%) in whom bronchoscopy was unhelpful. Six patients had diagnosis confirmed by other means while in 36 others (30%) it was based on clinical features and supportive basic investigations. There were no complications noted. We conclude that while sputum examination remains the mainstay for diagnosing pulmonary tuberculosis, fibreoptic bronchoscopy serves as a safe and useful adjunct.
    Matched MeSH terms: Middle Aged
  3. Tan CT, Leong S
    Singapore Med J, 1992 Dec;33(6):575-80.
    PMID: 1488664
    A study of visual evoked potential (VEP), brainstem evoked potential (BAEP) and median nerve somatosensory evoked potential (SSEP) in 26 Malaysian patients with clinically definite Multiple Sclerosis (MS). This study showed an overall high rate of abnormality, with 85% of patients for VEP, 31% for BAEP and 65% for median nerve SSEP. The rate of abnormality was particularly high for patients who were symptomatic, reaching 100% of patients for VEP, 50% of patients in BAEP, 83% of nerves for median nerve SSEP. The rate of abnormality among those who were asymptomatic was lower, varying from 32% of eyes in VEP, 27% of patients in BAEP and 31% of nerves in median nerve SSEP. Three out of 10 patients with optic spinal form of MS have abnormal BAEP. These show the usefulness of the evoked potential studies in confirming the clinical lesions as well as demonstrating subclinical involvement. The rate of abnormal evoked responses for the asymptomatic patients in this study is generally lower than that published elsewhere.
    Matched MeSH terms: Middle Aged
  4. Reddy SV, Win N
    Singapore Med J, 1990 Aug;31(4):338-40.
    PMID: 2255930
    Brain laryngeal mask (BLM) was used to assess its suitability in 50 spontaneously breathing patients by one lecturer and 4 Medical Officers. Insertion of the laryngeal mask was successful at the first attempt in 42 patients, second attempt in 7 and third attempt in one. The incidence of airway obstruction secondary to downfolding of the epiglottis, which was corrected by reinsertion, was 16%. Post-operative complications included clenching of teeth in 5 patients, vomiting in 2 and excessive salivation in 3. The incidence of sore throat was 10%.
    Matched MeSH terms: Middle Aged
  5. Varma SL, Sharma I, Chugh S
    Singapore Med J, 1992 Feb;33(1):67-9.
    PMID: 1598611
    A total of 1018 and 812 first degree relatives (FDR) of schizoprencies and controls respectively, were studied to find out the psychiatric morbidity in the families of paranoid and non-paranoid schizophrenia patients. The risk of schizophrenia and affective disorders was found to be independent of the probands subtype diagnosis. The risk for schizoid-schizotypal and paranoid personality disorders was found to be increased in the first degree relatives of paranoid schizophrenic, as compared to non-paranoid schizophrenic, thus suggesting that the psychopathology in the FDR may differ with the subtype diagnosis of the proband.
    Matched MeSH terms: Middle Aged
  6. Lee SH, Cheah DS, Krishnan MM
    Singapore Med J, 1990 Jun;31(3):217-20.
    PMID: 2392698
    Locally advanced or recurrent carcinoma of the breast poses difficult management problems. These fungating and discharging tumours severely impair the quality of life in these unfortunate patients. We report two cases successfully treated with omental transposition flaps and split skin grafts. The operation is described in detail and the results discussed. This technique was found to be safe, effective and rewarding.
    Matched MeSH terms: Middle Aged
  7. Tan CT, Rapport RL
    Singapore Med J, 1981 Jun;22(3):140-3.
    PMID: 7302620
    Language studies were done on four multilingual dextral Chinese patients who developed dysphasia from various causes. The left hemisphere appeared to be dominant for all the languages in the four patients. All the languages and dialects were universally involved during the development of dysphasia. In one patient,
    there was evidence of delayed restitution in the patient's mother tongue (Hokkien) comparing with Mandarin and English which were the languages used in the hospital and for reading.
    Matched MeSH terms: Middle Aged
  8. Kothare SN
    Singapore Med J, 1980 Dec;21(6):756-9.
    PMID: 7221588
    This is an analysis of ovarian neoplasms encountered in Sarawak during the period January 1976-December 1977. There were 149 benign and 36 primary malignant tumours with an incidence of 44.3 per cent and 23.6 per cent respectively, in neoplasms 01 the Reproductive System. Amongst the benign ovarian tumours Dermoid Cyst
    (Cystic Teratoma) was quite frequent (29.5 per cent). In malignant neoplasms Cystadenocarcinomas constituted 66.7 per cent of the total. A case each of Granulosa cell earcinoma, Adenoacanthoma and Endodermal sinus tumours, 4 of Dysgerminoma and 6 of metastatic ovarian tumours were also recorded.
    Matched MeSH terms: Middle Aged
  9. Ng SC, Kuperan P, Jayalakshmi P, Chua CT
    Singapore Med J, 1990 Feb;31(1):80-2.
    PMID: 2185555
    A 47-year old man had hypersplenism from massive splenomegaly, the cause of which was undetermined for 2 years. He was initially asymptomatic though there was mild pancytopenia. However, 18 months after presentation he manifested both clinical and haematological deterioration, almost succumbing to sepsis. Splenectomy finally provided a definite diagnosis of follicular lymphoma and also restored his blood counts to within normal range.
    Matched MeSH terms: Middle Aged
  10. Tan DSK, Dimitrakakis M, Mangalam S, Lopez CG, Ooi BG
    Singapore Med J, 1989 Feb;30(1):34-7.
    PMID: 2595386
    The prevalence of coinfection, superinfection and chronic infection with the hepatitis delta virus (HDV) was studied in 324 hepatitis B surface antigen (HBsAg)-positive Malaysians. Of these, 10.0% (5/50) had coinfection, 5.7% (11/194) had superinfection, but none of the 80 patients with chronic liver disease (CLD) or primary hepatocellular carcinoma (PHC) had chronic infection with HDV. The overall HDV infection was 4.9% (16/324). One of the coinfection cases acquired the HDV infection as early as 1982. HDV superinfection was detected mainly among IV drug abusers (20% or 7/35) and promiscuous males and females (13.6% or 3/22). They were all asymptomatic. Only 0.8% (1/125) apparently healthy blood donors was infected with HDV. None of the 12 multi-transfused patients examined were positive. Malaysia is the only Southeast Asian country examined so far in which HDV infection was detected. The reason could be that the IV drug abusers and the sexually promiscuous groups missed being examined in the other countries. Comparing the HDV infection rates in 4 categories of infected Malaysians (viz. acute hepatitis B patients, IV drug abusers, blood donors and CLD patients) with those of other countries, it was noted that the Malaysian rates were similar to the lowest in the range of prevalence rates of each category in the latter group. The rate of coinfection in a preliminary study in 1982-84 (9.0% or 1/11) was not very different from that obtained to date (10.0% or 5/50).(ABSTRACT TRUNCATED AT 250 WORDS)
    Matched MeSH terms: Middle Aged
  11. Yaacob H
    Singapore Med J, 1991 Feb;32(1):70-2.
    PMID: 2017711
    The radiographs of fifteen Malaysian patients with presenting ameloblastoma aged between 20-55 years (average 35 years) were studied for any peculiar local features. The most common features were cortical plate expansion (80%), corticated scalloped margin (67%), multiloculation (87%), and resorption of tooth roots (47%). The latter two features are constantly found in advanced tumour stage. As pain was not a frequent complaint, many Malaysian patients seek treatment only at a very late stage after the tumours have reached large dimensions. Although ameloblastomas may be diagnosed often through radiographs, it should not be relied upon solely.
    Matched MeSH terms: Middle Aged
  12. Ong HC, Chan WF
    Singapore Med J, 1977 Jun;18(2):100-4.
    PMID: 929220
    Benign cystic teratoma of the ovary has a varied incidence, varying from 30 to 50 per cent of all benign ovarian tumours. This tumour tends to occur in the reproductive age group (20 to 40 years), and the majority of patients are married with children. About 40 per cent of patients are symptomless. Of those with symptoms, abdominal pain and mass are the commonest. Torsion is the most frequent complication encountered, and the presence of acute pain should make one suspect this complication. The tumour is bilateral in 10 to 20 per cent of patients. This high bilateral occurrence places a responsibility on the gynaecologist to inspect the opposite ovary in all cases of unilateral dermoid cyst of the ovary at the time of laparotomy. Germ·layer derivatives are predominantly ectodermal in origin, although both mesodermal and entodermal derivatives occur frequently.
    Matched MeSH terms: Middle Aged
  13. Ti TK, Murugasu R, Yong NK
    Singapore Med J, 1976 Sep;17(3):153-6.
    PMID: 1019613
    The clinical features and pathology of 17 patients with gastrointestinal lymphoma are reviewed. The small intestine was the site most commonly involved. Emergency presentation was usual: 11 of the 17 patients presented as acute abdomen or gastrointestinal haemorrhage. The frequency of gastrointestinal lymphoma to carcinoma in the Chinese and Indians was comparable to that in the West but a higher frequency was found in the Malays and Orang
    Asli.
    Matched MeSH terms: Middle Aged
  14. Phoon WO, Alfred ER
    Singapore Med J, 1965 Sep;6(3):158-63.
    PMID: 5851268
    The circumstances, clinical features, complications and progress of eighty-one cases of stonefish stings are described. There were no fatalities, few complications and no lasting ill-effects. The various forms of treatment are discussed. The venomous fishes of Malaysia are briefly reviewed. It is concluded that stonefish stings occur fairly frequently in this country and that they are attended by appreciable morbidity, but that fatal cases or cases with lasting ill-health are probably rare.
    Matched MeSH terms: Middle Aged
  15. Kheok SW, Ong KO
    Singapore Med J, 2017 Sep;58(9):521-527.
    PMID: 28948289 DOI: 10.11622/smedj.2017087
    Benign periarticular, bone and joint lipomatous lesions are rare entities that are increasingly being identified using current imaging techniques. This pictorial review illustrates the wide range of imaging presentations of these lesions at various sites and their pathognomonic features. The main lesions reviewed include intraosseous lipoma, liposclerosing myxofibrous tumour, lipoma arborescens and intra-articular lipoma.
    Matched MeSH terms: Middle Aged
  16. Gan GG, Ching Ng DL, Leong YC
    Singapore Med J, 2022 Jul;63(7):376-380.
    PMID: 33472336 DOI: 10.11622/smedj.2021003
    INTRODUCTION: Although erectile dysfunction (ED) is one of known long-term complications among male lymphoma survivors, it is not commonly reported, particularly in Southeast Asia. This study aimed to determine the prevalence of ED in lymphoma survivors in Malaysia and its association with anxiety and depression, and effects on quality of life.

    METHODS: This was a cross-sectional study conducted at a tertiary hospital in Malaysia. Patients were all male lymphoma survivors. The self-administered International Index of Erectile Function questionnaire was used to screen for ED. The Hospital Anxiety and Depression Score questionnaire was used to assess for anxiety and depression, and quality of life was assessed using the European Organization for Research and Treatment of Cancer quality of life questionnaire.

    RESULTS: Overall, 106 patients were recruited. Mean age was 55.7 years, with 61.3% of patients aged above 50 years. Only 67.0% of patients were sexually active and 81.7% of these reported the presence of ED, with only 4.2% having severe ED. Prevalence of ED among younger patients (age ≤50 years old) was 64.5%.The most common reason given by patients who were not sexually active was fatigue. Age was the only factor found to be associated with ED (p <0.005) and severity of ED increased with age. There was no association between ED and psychological stress or quality of life.

    CONCLUSION: Prevalence of ED and absence of sexual activity in lymphoma survivors was high. This should serve as a reminder to the treating clinician to offer early treatment and counselling.

    Matched MeSH terms: Middle Aged
  17. Gheith OA, Nagib AM, Halim MA, Mahmoud T, Nair P, Abo-Atya H, et al.
    Iran J Kidney Dis, 2023 Jan;1(1):47-53.
    PMID: 36739490
    INTRODUCTION: Data regarding contrast-induced nephropathy (CIN) in kidney transplant (KT) recipients are scarce despite the distinct risk factors such as the use of immunosuppressive agents, sympathetic denervation, glomerular hyperfiltration, and high prevalence of the cardiovascular disease. This study aimed to determine the prevalence of CIN in KT recipients who received low-osmolality iodine-based contrast material (CM) for radiological assessment.

    METHODS: Between 2010 and 2020, 79 of the 3180 KT recipients followed at Hamed Al-Essa organ transplant center received low-osmolality iodine-based contrast for radiological assessment for various indications. Preventive measures including holding metformin, intravenous hydration, sodium bicarbonate and N-acetylcysteine were given before contrast administration. CIN was defined as an increase in serum creatinine of 25% from the baseline within 72 hours.

    RESULTS: The enrolled patients were divided into two groups: those who developed CIN (n = 7) and those with no increase in serum creatinine level (n = 72). The mean age of the patients was 52.1 ± 12.3 years; 44 of them were males, and the cause of end-stage kidney disease was mostly diabetic nephropathy. The pre-transplant demographics were comparable between the two groups. Fortyseven cases received contrast for coronary angiography, and 32 received it for a CT scan. The graft function deteriorated in group 1, but no significant difference was found between the two groups at the end of the study.

    CONCLUSION: CIN is not uncommon in KT recipients receiving CM, especially with ischemic heart disease. Risk stratification, optimizing hemodynamics, and avoiding potential nephrotoxins are essential before performing CM-enhanced studies in KT recipients.  DOI: 10.52547/ijkd.7165.

    Matched MeSH terms: Middle Aged
  18. Ariffin F, Isa MR, Nafiza MN, Mazapuspavina MY, Fadhlina AM, Palafox B, et al.
    Med J Malaysia, 2022 Sep;77(5):542-551.
    PMID: 36169064
    INTRODUCTION: Achieving optimal control of blood pressure is easier when those affected understand the risks and consequences of hypertension and the principles of management. It is particularly important in disadvantaged groups among whom blood pressure control is often poor. However, effective responses require evidence of the knowledge and beliefs of those affected. This was undertaken as part of a larger study of the therapeutic journeys followed by individuals living in B40 (bottom 40% by income) households in Malaysia, the Responsive and Equitable Health Systems-Partnership on Non- Communicable Diseases (RESPOND).This paper describes their reported knowledge of hypertension, health, and measures that can improve hypertensive control.

    MATERIALS AND METHODS: The communities were selected from rural and urban populations in four peninsular states (Selangor, Kelantan, Perak, and Johor). Following a multistage sampling approach, communities in each stratum were selected according to probability proportional to the size and identified based on national census data by the community and administrative registers. Households were randomly selected. Eligible individuals were those aged between 35 and 70 years old, self-reported or identified as hypertensive at screening. Informed consent was taken. A survey using validated questionnaires was conducted.

    RESULTS: The total number of respondents was 579. The mean age was 59.0 (95%: 58.4, 59.7) and more were women (71.5%) than men (28.5%). Regarding respondents selfreported level of hypertension knowledge, 2.9% reported having no knowledge at all, 80.1% had little knowledge, and 17.9% were very familiar. Among all respondents, 56.2% (95% CI: 50.7, 61.6) correctly answered at least four out of five objective knowledge questions.Almost all (91.5%) were aware that hypertension could cause a stroke. However, one-fifth believed it could cause cancer. Almost threequarters said that people with high blood pressure generally felt well (72.1%) and recognized that they should not stop taking their medication (70.7%). Most of the respondents knew that people should take their medication even if they feel well (73.6%). Although more than half (66.0%) of the respondents rated their health as poor. Interestingly, most did not perceive themselves as having a long-term illness (95.0%).

    CONCLUSION: This study provides reassurance that individuals with hypertension in disadvantaged communities in Malaysia have a relatively good understanding of hypertension. Further research should explore the challenges they face on their therapeutic journeys.

    Matched MeSH terms: Middle Aged
  19. Koh HP, Md Redzuan A, Mohd Saffian S, R Nagarajah J, Ross NT, Hassan H
    Am J Emerg Med, 2022 Oct;60:9-14.
    PMID: 35872375 DOI: 10.1016/j.ajem.2022.07.021
    INTRODUCTION: Some guidelines had recommended "thrombolysis first" in ST-elevated myocardial infarction (STEMI) during the Coronavirus Disease 2019 (COVID-19) outbreak. The impact of COVID-19 solely on STEMI thrombolysis is lacking as most studies reported outcomes related to percutaneous coronary intervention (PCI) setting. Thus, this study aimed to assess the impact of the COVID-19 pandemic on STEMI thrombolysis outcomes and the Emergency Department's performance in a non-PCI capable centre.

    METHODS: This single-centre retrospective study analysed data on consecutive STEMI patients who received thrombolytic therapy from May 2019 to December 2020 (20 months) in a non-PCI capable tertiary hospital. Total population sampling was used in this study. We compared all patients' characteristics and outcomes ten months before and during the pandemic. Regression models were used to assess the impact of COVID-19 pandemic on door-to-needle time (DNT), mortality, bleeding events, and the number of overnight stays.

    RESULTS AND DISCUSSION: We analysed 323 patients with a mean age of 52.9 ± 12.9 years and were predominantly male (n = 280, 88.9%). There was a 12.5% reduction in thrombolysis performed during the pandemic. No significant difference in timing from symptoms onset to thrombolysis and DNT was observed. In-hospital mortality was significantly higher during the pandemic (OR 2.02, 95% CI 1.02-4.00, p = 0.044). Bleeding events post thrombolysis remained stable and there was no significant difference in the number of overnight stays during the pandemic.

    CONCLUSION: STEMI thrombolysis cases were reduced during the COVID-19 pandemic, with an inverse increase in mortality despite the preserved Emergency Department performance in timely thrombolysis.

    Matched MeSH terms: Middle Aged
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