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Sungai Petani, Malaysia

Kamaluddin A.,Hospital Sultanah Bahiyah | Hussein S.A.S.,Hospital Sultanah Bahiyah | Hussein H.M.,Hospital Sultan Abdul Halim | Mohamed F.L.,Hospital Sultanah Bahiyah | Bakar N.A.,Hospital Sultanah Bahiyah
Bangladesh Journal of Medical Science | Year: 2014

Repeated dose of adrenaline in anaphylaxis is limited evidence in clinical setting. Hence, the usage is depending on physician best interest and knowledge. We reported a case of repeated doses of adrenalin was given through nebulizer and intravenous in anaphylaxis. We believed the unusual circumstances of this case was likely to be repeated on some readers' clinical practice and this mode of treatment is an adjunct to consider in such cases especially in Emergency Department (ED). Source

Zainuddin N.,University Technology of MARA | Abdullah O.,Hospital Sultan Abdul Halim
Malaysian Family Physician | Year: 2015

Discharging ear is a common symptom in the primary care and private general clinics. Most of the cases are treated with the antibiotic ear drops for otitis externa or otitis media. However, despite an adequate standard therapy, a malignant tumour can also be present with non-specific symptom such as ear discharge, especially in the case of persistent ear discharge. In this paper we have reported a case of an adult woman presented with non-resolving ear discharge who was treated repeatedly with antibiotic ear drop, which was later diagnosed as squamous cell carcinoma. © Academy of Family Physicians of Malaysia. All Rights Reserved. Source

Koh K.-H.,Sarawak General Hospital | Tan C.H.H.,Sarawak General Hospital | Hii L.W.S.,Sarawak General Hospital | Lee J.,Sarawak General Hospital | And 7 more authors.
Toxicology Reports | Year: 2014

Paraquat poisoning resulted in multiorgan failure and is associated with high mortality. We audited 83 historical cases of paraquat poisoning in past 2 years treated with conventional decontamination and supportive treatment, followed by enrolling 85 patients over a 2 year period into additional immunosuppression with intravenous (i.v.) methylprednisolone and i.v. cyclophosphamide.Our results showed that age, poor renal function and leucocytosis are the main predictors of fatal outcome. Immunosuppression regime rendered higher survival (6 out of 17 patients (35.3%)) versus historical control (1 out of 18 patients (5.6%)) (p=0.041) in the cohort with admission eGFR<50ml/min/1.73m2 and WBC count>11,000/μL.In contrast, there was no difference in survival with immunosuppression regime (38 out of 64 patients (59.4%)) compared to historical control (30 out of 52 patients (57.7%)) (p=0.885) in those with eGFR>50ml/min/1.73m2 or WBC<11,000/μL at presentation.Multivariable logistic regression showed survival probability. = exp(logit)/(1. +. exp(logit)), in which logit. = 13.962. - (0.233. ×. ln(age (year))). - (1.344. ×. ln(creatinine (μmol/L))). - (1.602. ×. ln(rise in creatinine (μmol/day))). - (0.614. × ln(WBC (,000/μL))). +. (2.021. ×. immunosuppression) and immunosuppression. = 1 if given and 0 if not. Immunosuppression therapy yielded odds ratio of 0.132 (95% confidential interval: 0.029-0.603, p= 0.009).In conclusion, immunosuppression therapy with intravenous methylprednisolone and cyclophosphamide may counteract immune mediated inflammation after paraquat poisoning and improve survival of patients with admission eGFR<50ml/min/1.73m2 and WBC count>11,000/μL. © 2014 The Authors. Source

Said M.A.,University of Malaya | Sulaiman A.H.,University of Malaya | Habil M.H.,University of Malaya | Das S.,National University of Malaysia | And 4 more authors.
Singapore Medical Journal | Year: 2012

Introduction This study aimed to determine the prevalence of metabolic syndrome and risk of coronary heart disease (CHD) in patients with schizophrenia receiving antipsychotics in Malaysia. Method s This cross-sectional study, conducted at multiple centres, involved 270 patients who fulfilled the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-TR diagnostic criteria for schizophrenia, were on antipsychotic medications for at least one year, and were screened for metabolic syndrome. Patients receiving mood stabilisers were excluded. Metabolic syndrome was defined according to the National Cholesterol Education Program ATP III criteria modified for Asian waist circumference. Risk for cardiovascular disease was assessed by using Framingham function (all ten-year CHD events). Results The prevalence of metabolic syndrome was 46.7% (126/270). Among all the antipsychotics used, atypical antipsychotics (monotherapy) were most commonly used in both the metabolic and non-metabolic syndrome groups (50.8% vs. 58.3%). The ten-year risk for CHD was significantly higher in patients with metabolic syndrome. The proportion of patients with high/very high risk for CHD (Framingham ≥ 10%) was greater in patients with metabolic syndrome than in those with non-metabolic syndrome (31.5% vs. 11.0%, odds ratio 3.9, 95% confidence interval 2.0-7.6; p < 0.001). The mean body mass index was higher in patients with metabolic syndrome than in those without (29.4 ± 5.1 kg/m2 vs. 25.0 ± 5.6 kg/m2; p < 0.001). Conclusion Patients with schizophrenia receiving antipsychotics in Malaysia have a very high incidence of metabolic syndrome and increased cardiovascular risk. Urgent interventions are needed to combat these problems in patients. Source

Thean Hock T.,Universiti Sains Malaysia | Bogdanova N.,University of Munster | Kai Cheen A.,Universiti Sains Malaysia | Kathirgamanathan S.,Hospital Sultan Abdul Halim | And 6 more authors.
Reproductive BioMedicine Online | Year: 2015

Recurrent spontaneous abortion (RSA) is a prevalent condition among the Malay population of Malaysia, where carriage risk of conventional hereditary thrombophilia factors has been generally ruled out. The contribution of M2/ANXA5, a common haplotype in the annexin A5 gene promoter, was evalauted for RSA in Malay. Seventy-seven women who had experienced two or more unexplained RSA and 41 available male partners were selected for study, with 360 population controls recruited from healthy Malay individuals. Incidence of M2 carriage and odds ratios were calculated between control and patient groups, and clinically defined subgroups and RSA risk was evaluated. M2/ANXA5, found in 42.2% of the general Malay population, was associated with greater risks for women with primary and secondary RSA with early (gestational week 5-15) losses. The risk was somewhat higher in Malay couples when both partners were carriers and a trend of higher prevalence was seen for the male partners patients who had experienced RSA. M2 carriage seems to be a risk factor with unusually high incidence in Malay women and couples with primary and secondary RSA with 'early' spontaneous abortions. The associated male partner risk confirms the proposed role of M2/ANXA5 as a genetic trait impeding embryonic anticoagulation. © 2014 Reproductive Healthcare Ltd. All rights reserved. Source

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