MyMedR

Fulltext Foreign bodies in the vagina after childbirth

Goh TH

Med J Malaysia, 1985 Mar;40(1):54-5.

Effect of laparoscopic sterilization and insertion of Multiload Cu 250 and Progestasert IUDs on serum ferritin levels

Goh TH, Hariharan M

Contraception, 1983 Oct;28(4):329-36.

Blood haemoglobin and serum ferritin levels were measured at the initial visit and 12 months following sterilization and IUD insertion. Ferritin levels were unaltered in Progestasert users after 12 months but haemoglobin values increased though not significantly. Ferritin levels fell in Multiload Cu 250 users and in sterilized women; haemoglobin levels were also observed to fall but significantly only in the latter group. Iron-deficiency anaemia was prevalent at initial contact and there appeared to be an increased risk subsequently in Multiload Cu 250 users and in those who were sterilized. Screening and monitoring for anaemia is indicated. From the viewpoint of iron status, the Progestasert is preferable to the Multiload Cu 250 but it suffers the major disadvantages of needing frequent replacement and of causing menstrual disturbances which might compromise its acceptability. Menstrual blood loss studies may help explain why anaemia develops after sterilization.

Fulltext Iron-deficiency anaemia and serum ferritin levels in Malaysian women

Goh TH, Hariharan M

Med J Malaysia, 1986 Dec;41(4):300-4.

PMID: 3670151

Serum ferritin and blood haemoglobin levels were studied in 229 women attending a family planning clinic. Ferritin values ranged from 2 to 438 Jlg/l and was skewed with an arithmetic mean of 41.8 and geometric mean of 23.4 flg/l; 26.6% were iron-deficient (ferritin < 12 Jlg/l). Haemoglobin values were normally distributed with a mean of 11. 7 g/dl but 59% were anaemic (Hb < 12 gjdl]. The correlation between ferritin and haemoglobin values was poor (r = 0.147) but almost all women with a haemoglobin below 10 g/dl were iron-deficient. This study reaffirms the need for monitoring iron-deficiency anaemia in apparently healthy women seeking contraception.

Serological screening for syphilis during pregnancy in a multiethnic Asian population

Goh TH, Ngeow YF

Asia Oceania J Obstet Gynaecol, 1989 Mar;15(1):67-70.

PMID: 2735843

Out of 14,841 women who were serologically examined for syphilis at the antenatal booking clinic, University Hospital, Kuala Lumpur in Malaysia, 1.78% were VDRL positive and 1.05% TPHA positive with significant differences between the Malays, Indians and Chinese. These rates are higher than published series and were attributed to childhood yaws infection among the Malays. As differentiation between yaws and syphilitic infection in the clinic is difficult, all TPHA-reactive women were treated as for syphilis. Congenital syphilis was not diagnosed in those women who had been effectively treated before delivery.

Fulltext Retained Graefenberg ring intrauterine device mimicking fractured Lippes loop in-utero

Goh TH, Kuan BB

Med J Malaysia, 1985 Mar;40(1):44-5.

PMID: 3831735

A retained Graefenberg , ring intrauterine. contraceptive device which looked like a fractured Lippes loop on pelvic radiography is presented, and its management outlined.

Menstrual flow duration and spotting following Multiload Copper 250 intra-uterine device insertion

Goh TH, Ang ES, Yip YC

J Obstet Gynaecol (Lahore), 1983 Oct;4(2):127-8.

PMID: 12279948

Screening for gonorrhea in a prenatal clinic in Southeast Asia

Goh TH, Ngeow YF, Teoh SK

Sex Transm Dis, 1981 4 1;8(2):67-9.

PMID: 7256495

Screening by culture of endocervical specimens revealed four cases of gonorrhea among 744 pregnant women attending the prenatal clinic at the University Hospital in Kuala Lumpur, Malaysia. The observed prevalence of gonorrhea (0.54%) in pregnant women is similar to that in Great Britain (0.2-0.7%), but lower than the prevalences reported for North America (2.5-7.5%) and Thailand (11.9%). The results indicate that routine screening of pregnant women attending prenatal clinics in Malaysia would aid in the control of gonorrhea in that country.

A longitudinal study of serum iron indices and haemoglobin concentration following copper-IUD insertion

Goh TH, Hariharan M, Tan CH

Contraception, 1980 Oct;22(4):389-95.

PMID: 7449387

The increase in menstrual blood loss associated with copper-bearing IUDs may cause or aggravate pre-existing anaemia. In order to evaluate this risk, 84 Malaysian women wearing copper-IUDs were studied longitudinally by means of serial measurements of blood haemoglobin concentration (Hb), serum iron (S/Fe) and transferrin saturation (T/S). The initial Hb was under 12 gm% in 33.7% of patients. The mean Hb showed no significant change up to 12 months while S/Fe fell significantly at the end of this time; the T/S was significantly reduced as early as 6 months post-insertion. There is a significant risk of anaemia following copper-IUD insertion, particularly with long-term usage. Progestogen-releasing IUDs may offer the most feasible solution to this problem in our local context since oral medication with iron or drugs to reduce menstrual blood loss is not practicable.

Cardiac arrhythmias in acute myocardial infarction

Ng WH, Goh TH, Ishak E, Ahmad Z

Med J Malaysia, 1979 Dec;34(2):131-5.

PMID: 548713

Fulltext Awareness of diastolic heart failure as a disease entity among Malaysian doctors -- a questionnaire survey from three general hospitals

Choo WS, Loh LC, Goh TH, Omar I

Med J Malaysia, 2011 Oct;66(4):350-2.

PMID: 22299556

The concept of diastolic heart failure (DHF) is not new. However awareness and understanding on this subject may remains uncertain among medical practitioners. We wished to examine the extent of awareness of such entity among doctors in Malaysia. A questionnaire was designed and distributed randomly during hospital Continuous Professional Development (CPD/CME) sessions and also in the respective outpatient departments (OPD) between July to October 2008. This cross-sectional survey in three urban-based general hospitals showed that there are a significant proportion of doctors who are lack of understanding and awareness of diastolic heart failure.

Study site: Hospital Pulau Pinang, Georgetown, Pulau Pinang, Hospital Tuanku Ja’afar Seremban, Bukit Rasah, Seremban, Hospital Ampuan Najihah Kuala Pilah, Negeri Sembilan.

A study of menstrual patterns following laparoscopic sterilization with silastic rings

Goh TH, Puvan IS, Wong WP, Sivanesaratnam V, Sinnathuray TA

Int. J. Fertil., 1981;26(2):116-9.

PMID: 6114062

The menstrual patterns of 281 women undergoing laparoscopic sterilization with silastic rings were studied prospectively. A significant increase in dysmenorrhea and irregular periods was seen soon after sterilization but this was transient, returning to presterilization levels by 12 months. Menorrhagia was not observed and the amount of menstrual blood loss showed a trend towards normal following sterilization. No permanent adverse effects on menstrual patterns were seen in the 1st year after sterilization. It is suggested that factors other than the sterilization procedure may be responsible for the high prevalence of menstrual dysfunction that has been reported following sterilization.

Early experience with the copper 7, copper T220C and multiload 250 intrauterine devices

Goh TH, Tan CH, Lim SM, Chew SC, Hutapea H, Iskandar J

Med J Malaysia, 1978 Jun;32(4):304-7.

PMID: 732628

Anti-hypertensive prescription practices in private hospitals in Malaysia: a prospective, non-interventional, observational study

Ng WK, Philip AZ, Lim TT, Wong M, Goh EL, Tengku Ismail TS, et al.

Med J Malaysia, 2023 May;78(3):350-356.

PMID: 37271845

INTRODUCTION: In managing hypertension, monotherapy and sometimes a combination of more than one agent are used to achieve blood pressure (BP) control. The objective of this prospective, observational, multi-centre study was to assess the level of BP control in patients receiving one or more anti-hypertensive drugs in private medical centres in Malaysia according to the treatment regimens (monotherapy, free drug combinations and single pill combinations).

MATERIALS AND METHODS: Data were collected through medical records and interview sessions with patients on current pharmacotherapy for hypertension management at baseline and 2-3 months later. Results are expressed as mean ± SD for continuous data and as frequencies and percentages for categorical data.

RESULTS: Among 182 recruited patients, 89 (49%) achieved BP control by the end of the study. Majority (62/89) patients were on single-pill (monotherapy or SPC) antihypertensives. Majority (63/89) required more than two antihypertensives to achieve BP control.

CONCLUSION: Both SPC and free drug combination antihypertensives reduced BPs, but physicians preferred SPC to improve BP control and increase treatment compliance.

Fulltext Biatrial thrombi resembling myxoma regressed after prolonged anticoagulation in a patient with mitral stenosis: a case report

Lu HT, Nordin R, Othman N, Choy CN, Kam JY, Leo BC, et al.

J Med Case Rep, 2016 Aug 10;10(1):221.

PMID: 27510438 DOI: 10.1186/s13256-016-1018-0

BACKGROUND: Many cases of cardiac masses have been reported in the literature, but in this case report we described a rare case of biatrial cardiac mass that represented a challenge for diagnosis and therapy. The differentiation between cardiac masses such as thrombi, vegetations, myxomas and other tumors is not always straightforward and an exact diagnosis is important because of its distinct treatment strategy. Transthoracic/esophageal echocardiography and cardiac magnetic resonance play an important role in establishing the diagnosis of cardiac masses. However, no current noninvasive diagnostic tool has the ability to absolutely diagnose cardiac masses; obtaining a pathological specimen by surgical resection of cardiac masses is the only reliable method to diagnose cardiac masses accurately. Our case report is an exception in that the final diagnosis was affirmed by empirical anticoagulation therapy based on clinical judgment and noninvasive characterization of biatrial mass.

CASE PRESENTATION: We described a 54-year-old Malay man with severe mitral stenosis and atrial fibrillation who presented with a biatrial mass. Transthoracic/esophageal echocardiography and cardiac magnetic resonance detected a large, homogeneous right atrial mass typical of a thrombus, and a left atrial mass adhering to interatrial septum that mimicked atrial myxoma. The risk factors, morphology, location, and characteristics of the biatrial cardiac mass indicated a diagnosis of thrombi. However, our patient declined surgery. As a result, the nature of his cardiac masses was not specified by histology. Of note, his left atrial mass was completely regressed by long-term warfarin, leaving a residual right atrial mass. Thus, we affirmed the most probable diagnosis of cardiac thrombi. During the course of treatment, he had an episode of non-fatal ischemic stroke most probably because of a thromboembolism.

CONCLUSIONS: Noninvasive characterization of cardiac mass is essential in clarifying the diagnosis and directing treatment strategy. Anticoagulation is a feasible treatment when the clinical assessment, risk factors, and imaging findings indicate a diagnosis of thrombi. After prolonged anticoagulation therapy, complete resolution of biatrial thrombi was achievable in our case.

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