MyMedR

Fulltext A baby with an abnormal upper limb

Keah SH

Malays Fam Physician, 2008;3(2):108.

PMID: 25606130

Fulltext A man with claw hand

Keah SH

Malays Fam Physician, 2008;3(3):163.

PMID: 25606145

Fulltext Exercise-induced rhabdomyolysis with acute renal failure after strenuous push-ups

Keah SH, Chng KS

Malays Fam Physician, 2009;4(1):37-9.

PMID: 25606158

We report a case of a young Chinese female who developed acute rhabdomyolysis with acute renal failure after a strenuous push-up exercise during a company motivation course. She managed to make full recovery after a period of outpatient treatment.

Fulltext Prevalence of diabetic retinopathy in a primary care setting using digital retinal imaging technology

Keah SH, Ch'ng KS

Malays Fam Physician, 2006;1(1):19-22.

PMID: 26998203 MyJurnal

The objective of this study was to determine the prevalence of diabetic retinopathy in a primary care setting using digital retinal imaging technology and to quantify the degree of diabetic retinopathy using internationally accepted severity scales. Two hundred patients with type 2 diabetes were evaluated clinically followed by fundus photography. The prevalence of retinopathy and maculopathy was 47.4% and 59.2% respectively (both retinopathy and maculopathy 34.7%). The high prevalence of retinal abnormality in this study is a cause for concern as most patients had diabetes for only 5 years or less.

Fulltext Retinal Images

Keah SH, Chng KS

Malays Fam Physician, 2006;1(1):39.

PMID: 26998211

Basal Cell Carcinoma Surgery in general practice: Is there a role for the local General Practitioner?

Keah SH, Ng SC

Malays Fam Physician, 2020;15(3):10-21.

PMID: 33329859

Basal cell carcinoma (BCC) is a common disease of the skin caused principally by prolonged solar radiation exposure. It is normally a malignancy with favorable prognostic features and is potentially curable by standard excision. In White populations with high disease incidence, general practitioners (GPs) play a vital role in diagnosing and managing BCC, including surgical excision. Dedicated care at the primary care level by adequately trained GPs is conceivably cost effective for the health system and more convenient for the patient. In Asia and other parts of the world with low incidence, this valuable role of GPs may appear to be inconsequential. In this regard, any justification for the involvement of local GPs in BCC surgery is debatable. This article aims to provide a clinical update on essential information relevant to BCC surgery and advance understanding of the intricate issues of making a treatment decision at the primary care level.

Case Report: Madam Tan, a 71-year-old Malaysian Chinese lady, otherwise healthy, presented to her local GP with a complaint of a nodule over the left cheek that had been there for more than a decade. Her concern was that the lesion was growing and had become conspicuous. She had spent most of her life as a farmer working in her orchard.Upon examination, she had an obvious dome-shaped nodule over the left cheek measuring approximately 1.8 cm in diameter. The lesion was firm, pigmented, well-demarcated, and slightly ulcerated at the top. Clinically, she was diagnosed with a pigmented nodular basal cell carcinoma of the left cheek. Examination of the systems was unremarkable.She requested that the consulting GP remove the growth. The cost for specialist treatment and waiting time at the local hospital were her concerns.

Clinical Questions: Can the basal cell skin cancer be excised safely and effectively in the local primary care setting? What are the crucial preoperative concerns?

Fulltext Acute suppurative thyroiditis presenting as a painless thyroid swelling

Keah SH, Leong CK

Malays Fam Physician, 2006;1(2):54-57.

PMID: 27570587 MyJurnal

Acute suppurative thyroiditis is a rare disorder. We saw a 24 year old man with this condition that present atypically. The patient had a non-tender thyroid enlargement associated with fever and leukocytosis. FNA cytology clinched the diagnosis. The abscess was associated with Klebsiella pneumoniae septicemia and required surgical drainage after failing antibiotic therapy.

Fulltext Antimicrobial susceptibility of community-acquired uropathogens in general practice

Keah SH, Wee EC, Ch'ng KS, Keah KC

Malays Fam Physician, 2007;2(2):64-9.

PMID: 25606083 MyJurnal

Antibiotic resistance of urinary tract pathogens has increased worldwide. The purpose of this study is to provide information regarding local resistance pattern of urinary pathogens to the commonly used antibiotics. One hundred and seventeen cases of community-acquired urinary tract infections were studied. The most common group of patients was the uncomplicated acute cystitis in women. E. coli was the most common isolate. Overall, antimicrobial susceptibility test on the organisms isolated showed a resistance of 63.0% to ampicillin, 40.1% to sulfamethoxazole-trimethoprim (S-T), 14.3% to pipemidic acid, 8.6% to norfloxacin, 3.8% to cephalexin, 3.7% to amoxicillin-clavulanate, 1.0% to cefuroxime, and 1.0% to fosfomycin. Three out of five patients on ampicillin as well as two out of five patients on S-T were likely to be inadequately treated.

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