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  1. Fulltext Suboptimal Therapy for Dyslipidaemia in Coronary Bypass Surgical Patients with Premature Ischaemic Heart Disease
    Yong Sheng Tan NH, Sachithanandan A
    Med. J. Malaysia, 2015 Apr;70(2):114-5.
    PMID: 26162393 MyJurnal
    The incidence of premature multi-vessel coronary artery disease (CAD) is on the rise in Malaysia. The pathogenesis of coronary atherosclerosis is multi-factorial with dyslipidaemia being one such risk factor. Elevated total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and triglycerides (TG) levels are primarily responsible. We analysed the fasting pre-operative lipid profiles of coronary artery bypass graft (CABG) patients with symptomatic severe premature CAD. A majority of patients had an elevated LDL cholesterol level despite being on a statin. Similarly, no patient with an elevated TG level was prescribed a fibrate. Pre-operative control of known dyslipidaemia was suboptimal in young adults with angiographially proven severe symptomatic CAD. This is either due to subtherapeutic dose prescribing or failure to commence appropriate anti-lipid drugs. Collectively, general practitioners, cardiologists and cardiac surgeons must be more diligent in monitoring lipid profiles in such patients and be more meticulous in prescribing therapeutic doses to achieve target control.
    Matched MeSH terms: Retrospective Studies
  2. Causes of mortality in patients with psoriasis in Malaysia - Evidence from the Malaysian Psoriasis Registry
    Kwan Z, Yeoh CA, Mohd Affandi A, Alias FA, Hamid M, Baharum N, et al.
    Med. J. Malaysia, 2015 Oct;70(5):273-7.
    PMID: 26556114
    BACKGROUND: Patients with severe psoriasis, namely those requiring phototherapy or systemic treatment, have an increased risk of death. The aim of this study was to determine the prevalence, aetiology and risk factors for mortality among adult patients aged 18 years and above with psoriasis in Malaysia.

    METHODS: This was a retrospective study involving adult patients notified by dermatologists to the Malaysian Psoriasis Registry between July 2007 and December 2013. Data were cross-checked against the National Death Registry. Patients certified dead were identified and the cause of death was analysed. Multivariate analysis using multiple logistic regression were conducted on potential factors associated with higher risk of mortality.

    RESULTS: A total of 419 deaths were identified among the 9775 patients notified. There were four significant risk factors for higher mortality: age>40 years (age 41-60 years old, Odds Ratio (OR) 2.70, 95%CI 1.75, 4.18; age>60 years OR 7.46, 95%CI 4.62, 12.02), male gender (OR 1.72, 95%CI 1.33,2.22), severe psoriasis with body surface area (BSA) >10% (OR 1.52, 95%CI 1.19, 1.96) and presence of at least one cardiovascular co-morbidity (OR 1.67, 95% CI 1.30, 2.14). Among the 301 patients with verifiable causes of death, the leading causes were infection (33.9%), cardiovascular disease (33.6%) and malignancy (15.9%).

    CONCLUSION: Infection was the leading cause of death among psoriasis patients in Malaysia. Although cardiovascular diseases are well-known to cause significant morbidity and mortality among psoriasis patients, the role of infections and malignancy should not be overlooked.

    Matched MeSH terms: Retrospective Studies
  3. Fulltext The epidemiology and clinical spectrum of melioidosis in a teaching hospital in a North-Eastern state of Malaysia: a fifteen-year review
    Zueter A, Yean CY, Abumarzouq M, Rahman ZA, Deris ZZ, Harun A
    BMC Infect. Dis., 2016;16:333.
    PMID: 27423906 DOI: 10.1186/s12879-016-1583-2
    Over the last two decades, many epidemiological studies were performed to describe risks and clinical presentations of melioidosis in endemic countries.

    Study site: Hospital Universiti Sains Malaysia (HUSM)
    Matched MeSH terms: Retrospective Studies
  4. Fulltext Clinical evaluation of Dyslipidemia among type II diabetic patients at Public hospital Penang, Malaysia
    Zaki NF, Sulaiman AS, Gillani WS
    Int Arch Med, 2010;3:34.
    PMID: 21092333 DOI: 10.1186/1755-7682-3-34
    Global views emphasize the need for early; effective intervention against the atherogenic dyslipidemia associated with type 2 diabetes and metabolic syndrome to reduce the risk of premature cardiovascular diseases. Our aim was to determine the clinical practices and compliance among dyslipidemia with type II diabetes and hypertension in multiracial society.
    Matched MeSH terms: Retrospective Studies
  5. Chemotherapy extravasation at hospital pulau pinang, malaysia
    Tan AL, Phua VC
    Med. J. Malaysia, 2014 Jun;69(3):124-5.
    PMID: 25326352 MyJurnal
    PURPOSE: Extravasation with intravenous chemotherapy is a common complication of chemotherapy which carries the risk of devastating complications. This study aims to determine the rate of extravasation with intravenous chemotherapy in a major hospital where chemotherapy is delivered in various departments other than the oncology department.

    PATIENTS AND METHODS: All patients who underwent intravenous chemotherapy in the oncology department and surgical wards in Penang General hospital from 1st February 2008 till 31st June 2008 were recruited retrospectively for this study to look at the rate of extravasation.

    RESULTS: A total of 602 patients underwent intravenous chemotherapy during this period. Fifty patients received chemotherapy in the general surgical ward while another 552 patients received chemotherapy in the oncology department. There were 5 cases of extravasation giving an overall extravasation rate of 0.8% (5/602). however, 4 of these cases occurred in the general surgical ward giving it a rate of 8% (4/50).

    CONCLUSION: The rate of extravasation in our hospital was 0.8%. however, this rate can be significantly increased if it is not done under a specialized unit delivering intravenous chemotherapy on a regular basis. Preventive steps including a standard chemotherapy delivery protocol, staff and patient education must be put in place in all units delivering intravenous chemotherapy.

    Matched MeSH terms: Retrospective Studies
  6. Fulltext Factors associated with the outcome of open tibial fractures
    Yusof NM, Khalid KA, Zulkifly AH, Zakaria Z, Amin MA, Awang MS, et al.
    Malays J Med Sci, 2013 Oct;20(5):47-53.
    PMID: 24643115 MyJurnal
    Although open tibial fractures are common in Malaysia, the outcomes for these patients have not been evaluated in the literature. This retrospective study was conducted to examine the factors associated with infection and non-union in open tibial fractures managed at Hospital Tengku Ampuan Afzan (HTAA), Kuantan, in 2009.
    Matched MeSH terms: Retrospective Studies
  7. Fulltext Outcomes Following Surgery for Distal Rectal Cancers: A Comparison between Laparoscopic and Open Abdomino-Perineal Resection
    Tan KK, Chong CS, Tsang CB, Koh DC
    Med. J. Malaysia, 2013 Aug;68(4):348-52.
    PMID: 24145265
    Oncologic outcomes following laparoscopic abdomino-perineal resection (APR) for distal rectal cancer are infrequently reported. This study aims to compare the long term outcomes between laparoscopic and open APR in distal rectal cancers.
    Matched MeSH terms: Retrospective Studies
  8. Fulltext A study on the morphometric asymmetry of atlas vertebrae
    Shahrun Niza AS, Nani Harlina ML, Razrim R, Ussof Eskaandar MH, Rohaizak M
    Journal of Surgical Academia, 2016;6(1):25-31.
    MyJurnal
    A surgeon’s experience plays an important role in breast conserving surgery (BCS). The common conception is that, the more junior is the operating surgeon, the surgical margin will be wider or closer to the tumour edge. Thus the aim of this study is to look into the adequacy of surgical margin performed by different level of surgeons’ experience in patients whom underwent wide local excision (WLE) and hook-wire localization (HWL) in our surgical unit. The surgical experience of the operating surgeon and their surgical margins will be analyzed. This is a retrospective study from January 2000 to December 2012. Eighty-eight patients with early breast cancer underwent WLE and HWL by 3 different groups of surgeons (breast surgeons, junior surgeons and surgical registrars) were included. The surgical margins were analyzed for involved-margin, closed-margin or excessed-margin.The incidence of involved-margin, closed-margin and excessed-margin is the lowest among breast surgeons compared to other groups. However, the results were not statistically significant. The incidence of involved surgical margin is significantly higher within junior surgeons for HWL compared to the breast surgeons. The incidence of involved, closed or excessed surgical margin were lowest when performed by breast surgeon but not significantly different between the three groups. However, for HWL the breast surgeons significantly better compared to the other groups.
    Matched MeSH terms: Retrospective Studies
  9. Fulltext Test ordering pattern at the chemical pathology laboratory, hospital universiti sains malaysia
    Al-Joudi FS, Wahab NA, Nordin H
    Malays J Med Sci, 2003 Jan;10(1):46-51.
    PMID: 23365500 MyJurnal
    The utilization of the chemical laboratory resources at the Hospital Sains Malaysia was evaluated. More than 100,000 test requests received and performed over a 12-month period, were analyzed retrospectively. The analysis conducted included the abnormal results obtained, the degree of duplication of tests, and the extent of test-panel ordering. It was found that a relatively moderate degree of over-ordering was evident. The findings suggested that the main reasons for over-ordering were the use of panel tests of ordering, in addition to a small, yet significant degree of duplication. Strategies for cutting down the test ordering have been reviewed and discussed.
    Matched MeSH terms: Retrospective Studies
  10. Fulltext Use of Radiographic Densitometry to Predict the BoneHealing Index in Distraction Osteogenesis
    Saw, A., Manimaran, S., Faizal S., Bulgiba, A.M.
    Malays Orthop J, 2008;2(1):44-48.
    MyJurnal
    Bone lengthening with distraction osteogenesis involves prolonged application of an external fixator frame. Qualitative and quantitative evaluation of callus has been described using various imaging modalities but there is no simple reliable and readily available method. This study aims to investigate the use of a densitometer to analyze plain radiographic images and correlate them with the rate of new bone formation as represented by the bone healing index. A total of 34 bone lengthening procedures in 29 patients were retrospectively reviewed. We used an X-Rite 301 densitometer to measure densities of new callus on plain radiographs taken at 4 and 8 weeks after surgery. Patients aged below 16y had significantly lower BHIs indicating faster bone healing and shorter duration of treatment. The ratio of radiographic densities between centre and edge of the new bone measured from plain radiographs taken at 8 weeks correlated positively with the eventual BHI of the patient. This method provides a simple and easy way to predict the rate of bone healing at an early stage of treatment and may also allow remedial action to be taken for those with poor progress in bone formation.
    Matched MeSH terms: Retrospective Studies
  11. Fulltext Use of Unlocked Intramedullary Nailing in Winquist Type Iand II Femoral Isthmus Fracture
    Ling, H.T., Ng, W.M., Kwan, M.K., Fathi Aizuddeen, L.K., Tay, P.C.M.
    Malays Orthop J, 2008;2(1):17-22.
    MyJurnal
    Interlocked intramedullary nailing is accepted as the gold standard for femoral shaft fractures. However for Winquist type I and II femoral fractures at the isthmus region, unlocked intramedullary nailing (Küntscher nailing) is still a good option. We performed a retrospective study on 86 patients with a total of 88 femoral shaft fractures around the isthmus that presented at our institution between 1 January 1988 and 31 August 2003. All patients (84.1% Winquist type I and 15.9% Winquist Type II fractures) were treated with unlocked intramedullary nail. The average time to union was 16 weeks with 97.7% rate of union. There were two cases (2.3%) of infection and non-union each. Overall results were comparable to standard interlocking intramedullary nailing. We conclude that unlocked intramedullary nailing is a good treatment option for Winquist Type I and II femoral fracture around the isthmus with its good union rate and minimal complications.
    Matched MeSH terms: Retrospective Studies
  12. Fulltext Risperidone and olanzapne in-patient utilization in the University of Malaya Medical Centre, Kuala Lumpur
    Hatim, A., Yen, T.H.
    JUMMEC, 2006;9(1):23-29.
    MyJurnal
    The objective of this study was to compare in-patient drug use patterns, costs, and outcomes associated with risperidone or olanzapine in a naturalistic clinical setting. Retrospective chart reviews of 92 patients with psychotic disorders were conducted at the University of Malaya Medical Centre (UMMC). Data was collected from patients who were hospitalized and for whom risperidone or olanzapine was the drug of first choice for long-term pharmacologic treatment. Proportion of patients for whom efficacy of the studied treatment could be established (as rated by the treating physician) was higher, but not significantly, with risperidone compared to olanzapine (p = 0.46). The average dose of the studied medication was 2.9 ± 1.0 mg/day for risperidone and 9.7 ± 2.4 mg/day for olanzapine. The total cost was significantly higher (p
    Matched MeSH terms: Retrospective Studies
  13. Fulltext Distal Femoral Locking Compression Plate Fixation in Distal Femoral Fractures: Early Results
    Yeap, E.J., Deepak, A.S.
    Malays Orthop J, 2007;1(1):12-17.
    MyJurnal
    We conducted a retrospective review on eleven patients who were treated for Type A and C distal femoral fractures (based on AO classification) between January 2004 and December 2004. All fractures were fixed with titanium distal femoral locking compression plate. The patient’s ages ranged from 15 to 85 with a mean of 44. Clinical assessment was conducted at least 6 months post-operatively using the Schatzker scoring system. Results showed that four patients had excellent results, four good, two fair and one failure.
    Matched MeSH terms: Retrospective Studies
  14. Fulltext Tissue response of type 2 diabetics towards non-surgical periodontal therapy: a retrospective, comparative study with non-diabetics - a preliminary investigation
    Goh, Y.C., Lau, S.L., Ramanathan, A., Swaminathan, D.
    Ann Dent, 2013;20(2):24-28.
    MyJurnal
    The purpose of this study was to assess the tissue
    response of Type 2 diabetic subjects towards non surgical
    periodontal therapy as compared with matched, nondiabetic
    subjects. This was a retrospective, comparative
    study using periodontal case notes of 40 subjects attending
    undergraduates’ periodontal clinics (20 diabetics, 20 nondiabetics),
    who were selected based on the inclusion
    and exclusion criteria. Response towards non surgical
    periodontal therapy was assessed through three clinical
    periodontal parameters, namely plaque score, gingivitis
    score and number of periodontal pocket ≥5mm at the
    baseline and after initial non surgical periodontal therapy.
    Data obtained was then analyzed by SPSS Version 12.
    Both diabetic and non-diabetic subjects showed significant
    improvements (p-value = 0.021; 0.000; 0.001 and 0.010;
    0.014; 0.001) in all three parameters after the therapy.
    However, when comparison was made between the two
    groups, there was no significant difference (p-value = 0.913;
    0.892 and 0.903) in any of the parameters. Periodontal
    conditions improved clinically in both diabetic and nondiabetic
    subjects after non-surgical periodontal therapy.
    Therefore, both groups responded similarly towards the
    therapy and thus it can be postulated that well-controlled
    diabetic status does not have a significant effect on the
    outcome of periodontal therapy.
    Matched MeSH terms: Retrospective Studies
  15. Fulltext Clinical audit: the quality of intraoral periapical radiographic films
    Yap, Yee Wooi, Azillah Mohd Al, Nur’Adilah Ahmad Othman, Siti Norhazlin Mohd Said
    International Medical Journal Malaysia, 2017;16(21):1-1.
    MyJurnal
    Intraoral periapical radiographic film is essential and aids in diagnosis, treatment
    planning, monitoring treatment and monitoring lesion development. A poor image quality of
    radiographic film and poor record keeping of these radiographs can affect the clinician's decision
    making. This first audit was to evaluate the quality of radiographic images and the compliance in
    following the standard of recording and labeling of radiographic films. The objectives of this audit
    were; firstly to highlight any potential problems involving quality of radiographic films within the
    department. Second, to assess the compliance of record keeping and labeling of intraoral
    radiographs. Materials and Methods: The study was conducted in a retrospective manner in the
    year 2017 with a sample of 100 intraoral periapical radiographic films from the year 2015 to 2016 in
    Hospital Sultanah Bahiyah. Results: This first audit cycle demonstrated: Good quality of
    radiographic films: 13% (n= 13/100), Good compliance of record keeping and labeling of radiograph: 32% (n= 32/100).
    Matched MeSH terms: Retrospective Studies
  16. Fulltext Outcome of chiropractic therapy in idiopathic scoliosis – a preliminary study
    Mohd Nizam Haron, Syahirah Zeti Azham, Lyanna Annura Sallehudin, Nur Firzanie Kamaruddin, Ezreen Elia Izzaty Afindi
    Journal of Clinical and Health Sciences, 2017;2(2):26-30.
    MyJurnal
    The purpose of this study is to retrospectively report the results of scoliosis patients who underwent chiropractic therapy and to evaluate their outcome by looking at the potential to alter the natural progression of scoliosis after therapy.
    Methods: Retrospective data collection was conducted at a private chiropractic centre in Kuala Lumpur. The data was collected from patients between the ages of 16 to 19 years old. A total of eight patients with 14 scoliotic curvatures (six thoracic, six lumbar and two thoracolumbar), who met the inclusion criteria, were selected as subjects for this study. All subjects received the same chiropractic therapy program. The outcome of the therapy was assessed by measuring the Cobb’s angle on the erect spine as captured on an x-ray. The Cobb’s angle was measured at the first presentation (to establish a baseline) after 6 and 24 months of therapy.
    Results: The mean baseline Cobb’s angle for thoracic, lumbar and thoracolumbar scoliosis were 30.70 ± 19.40, 31.70 ± 12.30 and 25.00 ± 18.40 respectively. After 24 months of chiropractic therapy, there was no discernible effect on the magnitude of the Cobb’s angles on the subjects overall.
    Conclusion: Our study showed no significant reduction in spine curvature in patients with scoliosis using chiropractic therapy after 24 months.
    Matched MeSH terms: Retrospective Studies
  17. Early congenital syphilis: experience with 13 consecutive cases seen at the University Hospital, Kuala Lumpur
    Koh MT, Lim CT
    Singapore Med J, 1991 Aug;32(4):230-2.
    PMID: 1775999
    While it is not difficult to recognise the classical clinical features of congenital syphilis in most cases, some of them may present with unusual manifestations which can defy early diagnosis. We report our experience with 13 cases of early congenital syphilis over a period of 10 years from 1980 to 1989. Twelve of the thirteen patients were less than 3 months at presentation. There were two infants born prematurely and six of the babies were born with a low birthweight (less than 2.5 kg). All but four patients survived following treatment. Skin lesions either in the form of typical vesiculobullous eruption over the palms and soles or a maculopapular skin rash over the body were the most common presentation and was seen in 10 patients. Splenomegaly with or without hepatomegaly was the most consistent physical sign. Radiological changes in the form of periostitis and/or metaphysitis were seen in all cases where an X-ray of the long bones was performed. An elevated serum immunoglobulin M, though non-specific for the disease, was found to be a useful screening test for recent infection.
    Matched MeSH terms: Retrospective Studies
  18. Prevalence and treatment patterns of ranibizumab and photodynamic therapy in a tertiary care setting in Malaysia
    Mohamad NA, Ramachandran V, Ismail P, Mohd Isa H, Chan YM, Ngah NF, et al.
    Int J Ophthalmol, 2017;10(12):1889-1897.
    PMID: 29259909 DOI: 10.18240/ijo.2017.12.16
    AIM: To describe the prevalence and changes in treatment patterns of ranibizumab and photodynamic therapy (PDT) among retinal disease patients who attended the Ophthalmology Clinic in the tertiary care Hospital Selayang from 2010 to 2014.

    METHODS: Study subjects were recruited retrospectively using the Electronic Medical Record (EMR) database software in Hospital Selayang. Demographic data, medical history, diagnostic procedure, treatments and diagnosis of patients were recorded.

    RESULTS: The five-year analysis included 821 patients with a mean age of 65.9±11.73y. Overall, there were a higher number of males (63.1%) and a higher number of Chinese (47.4%) patients. Among the 821 patients, 62.9% received ranibizumab injection followed by 19.2% PDT therapy and 17.9% had ranibizumab combined with PDT therapy. Age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV) were the most common retinal eye diseases reported, recording prevalence of 25.0% and 45.6%, respectively. The trend in ranibizumab treatment was reported to increase while PDT showed a decrease in trend from year 2010 to 2014. In terms of treatment, following multiple logistic regression, AMD was associated with the subjects being more likely to have received ranibizumab monotherapy (P<0.001) while PCV was associated with more likely to have received PDT (P<0.001) and PDT combined with ranibizumab therapy (P<0.001).

    CONCLUSION: The tertiary care setting in Malaysia is consistent with management of patients from other countries whereby ranibizumab is the most common treatment given to patients with AMD, while PCV patients most commonly receive PDT and ranibizumab combined with PDT therapy.

    Study site: Ophthalmology Clinic, Hospital Selayang
    Matched MeSH terms: Retrospective Studies
  19. Fulltext Popliteal artery to tibial plateau distance at the knee level: a radiological study to assess injury risks in osteoarthritic knees using dual source dual energy CT scan
    Ezamin, A.R., Hasyma, A.H., Suppiah, S., Suraini, M.S., Arifaizad, A., Paisal, Hussin, et al.
    Pertanika Journal of Science & Technology, 2017;25(1):371-378.
    MyJurnal
    Popliteal artery injury is the most disastrous intraoperative complication during total knee replacement. This study aims to determine the mean distance between the popliteal artery (PA) and the tibial plateau in normal and osteoarthritic patients who underwent Dual Energy CT Angiography (CTA) of the lower limb.
    Materials and Methods: All CTA lower limb examinations from January 2013 to October 2014 were retrospectively reviewed. The distance between the PA the tibial plateau distance and the thickness of popliteus muscle were electronically measured. We used modified Kellgren and Lawrence’s Classification to grade the osteoarthritis in patients who underwent CT examinations regardless of symptoms.
    Results: There were a total of 126 patients who underwent CTA (93 males and 33 females). 54 of them were Malays, 47 Indians, and 24 Chinese. The mean age of patients was 58 years (range 16 to 92). The mean PA-totibial plateau distance was 9.9 mm for the right lower limb (range 2.5 mm to 17.2 mm) and 10.24 mm for the left (range 5.5 mm to 15.4 mm). There were no significant correlations between PA-to-tibial plateau distance with osteoarthritis grade, age, gender, and racial origin (P > 0.05); however, there was a positive
    correlation between PA-to-tibial plateau distances with popliteus muscle thickness (P = 0.000).
    Conclusion: Osteoarthritic condition in the knee does not reduce the popliteal artery to the tibial plateau distance. Hence, a higher osteoarthritic grade does not impose additional risks with regards to popliteal artery to tibial plateau distance, with relatively similar arterial injury risks compared to normal knees.
    Matched MeSH terms: Retrospective Studies
  20. Systemic lupus erythematosus pregnancies: a case series from a tertiary, East Malaysian hospital
    Teh CL, Wong JS, Ngeh NK, Loh WL
    Lupus, 2009 Mar;18(3):278-82.
    PMID: 19213870 DOI: 10.1177/0961203308096661
    We performed a retrospective study of all systemic lupus erythematosus (SLE) pregnancies during a two-year period (2006-2007) to describe the clinical features, maternal and foetal outcomes in our centre. There were 17 pregnancies in 16 women with SLE. Our patients have a mean age of 28.31 years (SD 5.24) and a mean disease duration of 38.62 months (SD 38.03). Our patients have complicated pregnancies: 35.3% have SLE flares, 21.1% have preeclampsia and 47.4% needed caesarean sections. There were 15.8% foetal losses and 12.5% preterm deliveries in our patients. All the foetal losses occurred in patients with severe SLE flares during pregnancies. Lupus pregnancies in our centre generally have a good maternal and foetal outcome comparable with developed countries. The low incidence of antiphospholipid syndrome, the high usage of hydroxychloroquine and the high SLE remission rate in our patients before conceptions are the possible factors contributing to the good outcome.
    Matched MeSH terms: Retrospective Studies
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