International Medical Journal Malaysia最新文献

{"title":"Asthma control in Hospital Tengku Ampuan Afzan, Kuantan, Malaysia: a cross-sectional study","authors":"Y. Kuan, C. H. Tan, C. M. Hong, S. How","doi":"10.31436/IMJM.V14I2.433","DOIUrl":"https://doi.org/10.31436/IMJM.V14I2.433","url":null,"abstract":"Introduction: Various initiatives and medications have been introduced to achieve better control of bronchial asthma. However total control according to Global Initiative for Asthma (GINA) remains elusive even at tertiary referral hospitals. Our study is to determine the level of asthma control (according to GINA 2009), Asthma Control Test (ACT) scores and the types of medications used among patients with bronchial asthma in a large tertiary hospital. Methods: A cross-sectional study of all patients with bronchial asthma who attended the Chest Clinic at Hospital Tengku Ampuan Afzan (HTAA) from 2009 to 2011. Patient demographics, self-administered ACT scores, GINA-defined level of asthma control and medications were documented. Results: 208 patients were recruited. There were 23.2%, 46.3% and 30.5% of patients with controlled, partly controlled and uncontrolled asthma respectively. The median ACT scores was 19 [inter quartile range (IQR) 6]. The most frequently used preventer therapy was inhaled long-acting β-agonist/corticosteroids (LABA/ICS) fixed-dose combination (61.7%), and 9.6% were not on preventer therapy. 75% of patients with controlled asthma were on LABA/ICS compared to 58.5% of the partly controlled and uncontrolled groups (p=0.039). Conclusion: The majority of the asthmatic patients attending the Chest Clinic at HTAA did not have GINA-defined controlled asthma. Patients with higher ACT scores had better control of asthma. There were more patients with controlled asthma who were on LABA/ ICS combination.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":"14 1","pages":"41-44"},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45374916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intertrochanteric fracture fixation with Dynamic Hip Screw: Is tip-apex distance measurement useful for predicting fixation failure?","authors":"Goh Kian Liang, Z. Zamzuri, S. MohdAriff, M. Ma","doi":"10.31436/IMJM.V15I1.404","DOIUrl":"https://doi.org/10.31436/IMJM.V15I1.404","url":null,"abstract":"Introduction: Application of dynamic hip screw (DHS) implant for the treatment of unstable intertrochanteric fractures continues to raise concern related to risk of lag screw cut-out with or without subsequent damage to the acetabulum. Measurement of tip-apex distances (TAD) has been recommended to guide the optimal placement of lag screw and to predict subsequent risk of screw cut-out. In this study, the value of TAD was evaluated to verify its usefulness. Methods: This is a retrospective study of 33 consecutive patients with intertrochanteric fracture treated with DHS. Demographic data of the patients were traced from their case notes. Post-operative radiographs were reviewed by focusing on measurement of TAD on anteroposterior and lateral radiographs. Radiographs at one year follow-up were reviewed to depict any fixation-related failure or complication. Results: Fifty two percent of patients did not achieved the recommended TAD of ≤ 25mm. The mean post-operative TAD was 25.9mm and elderly patients were likely to achieve TAD of ≤ 25mm. The overall complication rate of 6% was attributed to screw cut-out in two cases. The unstable left-sided fracture was identified to be a potential risk for screw cut-out or migration. Conclusion: TAD is a valuable measurement to guide optimal placement of lag screw during DHS fixation of intertrochanteric fracture.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":"15 1","pages":"31-34"},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45470453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging and Histopathology Correlation of Solid Papillary Carcinoma of the Breast : A Review of Four Cases.","authors":"S. Mia, M. Azwini, Nordashima As","doi":"10.31436/IMJM.V14I1.463","DOIUrl":"https://doi.org/10.31436/IMJM.V14I1.463","url":null,"abstract":"Solid papillary breast carcinoma is a rare type of breast carcinoma. We present four cases which highlight the radiological and histological findings of solid papillary carcinoma. Mammogram supplemented with ultrasound played an important role in detecting solid papillary carcinomas which usually presents as intraductal lesions or intracystic mass with Doppler signal. Excision biopsy is a better option than core biopsy as the latter modality may not be representative and the diagnosis of solid papillary breast carcinoma may be missed.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":"14 1","pages":"93-97"},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43267903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatic hydrothorax without ascites.","authors":"Z. Bitar, H. Fayed, Ee Al-Hamer, H. Hafiz","doi":"10.31436/IMJM.V7I2.785","DOIUrl":"https://doi.org/10.31436/IMJM.V7I2.785","url":null,"abstract":"ABSTRACT Hepatic hydrothorax (HH) in the absence of ascites is a rare complication of liver cirrhosis. A 58-year-old woman presented to our department with dyspnea because of massive right pleural effusion requiring chest tube drainage. Investigations confirmed chronic hepatitis C, She had no signs of hepatic failure or ascites but there was evidence of portal hypertension. After pleural drainage and standard treatment for ascites with restriction of salt intake and diuretic administration, the pleural effusion improved with minimal recurrence. KEYWORDS: Hepatic hydrothorax, Cirrhosis","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46684622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant Pyogenic Granuloma Gravidarum of the Hand","authors":"E. Khan, Ariff Ms, A. Eshagroni, N. H. M. Haflah, S. Abdullah, J. Sapuan","doi":"10.31436/IMJM.V13I2.480","DOIUrl":"https://doi.org/10.31436/IMJM.V13I2.480","url":null,"abstract":"We describe a case of a giant pyogenic granuloma affecting the left index finger of a 23-year-old pregnant lady requiring surgical excision. Pyogenic granuloma gravidarum is a benign hyperplastic lesion that commonly presents on oral mucosa, typically the gums, in approximately 5% of pregnant women. Skin lesions over the fingers are an unusual site during pregnancy with only a few cases reported in the literature. The lesion was excised and a diagnosis of lobular capillary haemangioma was made based on histopathological evaluation. We delayed surgery until after parturition since recurrence is likely to be lower due to lower levels of circulating oestrogen and progesterone. The prognosis is usually excellent following resection. However, recurrences have been reported regardless of the treatment method.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":"13 1","pages":"55-58"},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48439058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pilot study of the primary care management of knee osteoarthritis in the Northern States of Malaysia","authors":"A. Arshad, R. Rashid","doi":"10.31436/IMJM.V7I2.781","DOIUrl":"https://doi.org/10.31436/IMJM.V7I2.781","url":null,"abstract":"ABSTRACT Introduction: Primary care management of knee osteoarthritis OA has received little attention in the scientific literature and the main reason of this survey is to study and explore the variations and patterns of primary care management and assess both conventional and complementary therapy usage in knee OA in the primary care setting. Materials and Methods: A cross sectional survey of 100 randomly selected general practitioners (GPs) in the northern states of Malaysia (Kedah, Perlis, Pulau Pinang) was undertaken using questionnaires. The GPs involved were asked about basic knowledge of OA in terms of diagnosis, investigation, and treatment of OA. They were also asked their usage of conventional and complementary medication. Results: 80 (80%) GPs responded to the questionnaires sent. 85% of GPs were in solo practice and 15% in group practice. Most of the GPs surveyed (69%) were in practice for more than 10 years, 21% in 5- 10 years and 10% were in practice for less than 5 years. 65% GPs surveyed see an average of more than 20 patients per week, 25% see about 10- 20 patients and 10% see less than 10 patients per week. 75% of GPs surveyed would arrange an X-ray. 65% of GPs surveyed will arrange a blood test, mostly serum uric acid, rheumatoid factor and ESR. Pharmacological management consists of first line treatment with analgesics (32%), NSAIDs (59%) or a combination of the two (4%). Non-pharmacological management consist of advise an exercise (37%), weight reduction (23%) and referral to physiotherapy (8%). 89% of GPs surveyed prescribed some form of complementary medications. 68% prescribed glucosamine sulphate, 29% chondroitin sulphate, 18% cod liver oil, 12% evening primrose oil. Only 5% of GPs surveyed perform intra- articular injection. Conclusion: The data suggest that in the primary care, majority of GP over investigate the diagnosis of OA. Pharmacological interventions largely concentrate on analgesic and NSAIDs. The use of physiotherapy and non drug approach were enormously under-utilized. There is a need to further educate GPs in the management of OA. KEYWORDS: Osteoarthritis, Management, Primary care","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41790027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Mesh Augmentation of the Hiatal Repair with Gore Bio-A® Improve Symptomatic Outcomes in Laparoscopic Fundoplication?","authors":"N. Kosai","doi":"10.31436/IMJM.V14I1.455","DOIUrl":"https://doi.org/10.31436/IMJM.V14I1.455","url":null,"abstract":"Introduction: Laparoscopic fundoplication is performed for the management of symptomatic hiatus hernias and gastro-oesophageal reflux disease (GORD) refractory to medical therapy. We adopted the use of Gore Bio-A® for selected laparoscopic hiatus hernia repairs in 2011 and with this case series aimed to establish whether mesh augmentation affects symptomatic outcomes. Methods: A retrospective review of prospectively collected data from all laparoscopic fundoplications performed by a single surgeon between October 2011 and January 2013 was performed. Patient specific data were entered into a proforma and analysed using Microsoft ExcelTM. Patient reported outcomes were assessed with a system specific quality of life questionnaire (GORD-HRQL) both pre and post-operatively. Results: Twenty-three patients underwent laparoscopic fundoplication during the study period. Gore Bio-A® re-enforcement of the hiatal repair was used in 14 patients and was the preferred option for those with pre-operative evidence of a large hiatus hernia. Whilst overall there was a statistically significant difference between pre and post-operative scores (21 vs 0, p=<0.0001, Mann-Whitney U test), there was no clear difference observed in pre-operative scores (22 vs 20, p=0.21, Mann-Whitney U test), postoperative scores (0 vs 0, p=0.92, Mann-Whitney U test) or symptom improvement (21 vs 20, p=0.24, Mann- Whitney U test) between the mesh and non-mesh groups. Conclusions: Augmentation of the hiatal repair with biosynthetic mesh is safe, feasible and may contribute to improved symptomatic outcomes in selected cases with a large hiatus hernia. We suggest a further assessment with a larger randomised sample and long term follow-up for definitive evaluation.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":"14 1","pages":"43-48"},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41478002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Controlling Dengue: An uphill task?","authors":"N. M. Amjad","doi":"10.31436/IMJM.V14I1.442","DOIUrl":"https://doi.org/10.31436/IMJM.V14I1.442","url":null,"abstract":"Mosquito-borne dengue viral fever is one of the fastest spreading global health hazards of recent times. Although it has been widespread especially in the tropics, dengue came into prominence since the early 1950’s following the epidemic in south East Asia. The commonest presentation of Dengue Fever is characterized by high fever, severe headaches, muscle pain and skin rash. This is the primary form and is less serious than the deadly secondary form referred to as Dengue hemorrhagic fever. The latter mainly affects most Asian and Latin American countries and has become a leading cause of hospitalization and death among children in these regions.1 It is estimated that 390 million dengue infections occur per year of which about 25% present with clinical manifestations.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":"14 1","pages":"01"},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69715753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conserved Peptide with Therapeutic Potential to Overcome Nasopharyngeal Carcinoma","authors":"M. Rifa’i, S. Widyarti, N. Widodo","doi":"10.31436/IMJM.V13I1.490","DOIUrl":"https://doi.org/10.31436/IMJM.V13I1.490","url":null,"abstract":"ABSTRACT Nasopharyngeal carcinoma (NPC) is a squamous-cell carcinoma that arises in the upper lining epithelium of the nasopharynx. In this study, conserved peptide (Ulin-1) of Epstein-Barr virus constructed by Biomodelling and Biocomputation was tested for its ability to stimulate B cells to produce specific antibodies. Spleen cells were isolated and cultured with anti-CD3 and lipopolysaccharide (LPS), and treated or not treated with Ulin-1. Cell culture was harvested six days after incubation and analyzed by flow cytometry. Here, we demonstrated the ability of Ulin-1 to stimulate B cells to produce specific antibodies. The results of this study illustrate the importance of Ulin-1 engineered by Biomodelling and Biocomputation as both active and passive immunization agents against nasopharyngeal cancer. KEYWORDS: Nasopharyngeal carcinoma, Ulin-1, gp 350/220, in vitro.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69715009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Median Nerve Compression by Gouty Tophi: A Case Report","authors":"I. Raffael, S. Rajesh","doi":"10.31436/IMJM.V14I1.461","DOIUrl":"https://doi.org/10.31436/IMJM.V14I1.461","url":null,"abstract":"We describe a case of median nerve compression by gouty tophi. This is a rare condition and presented with loss of function with paraesthesia of both hands in addition to multiple tophis. Surgery was chosen for immediate relief, where a debulking of left flexor digitorum superficialis with decompression of carpal tunnel was done and resulted in improvement of symptoms but became complicated due to inadequate physiotherapy.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":"14 1","pages":"87-91"},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48441771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}