MyMedR

Background: Plasma calcitonin gene-related peptide (CGRP) plays a key role in the migraine pathophysiology. This study aimed to investigate its role in predicting diagnosis and outcome of pharmacotherapy in pediatric migraine. Methods: We prospectively recruited 120 subjects, who never took migraine-preventive agents in a pediatric clinic, including 68 patients with migraine, 30 with non-migraine headache (NM), and 22 non-headache (NH) age-matched controls. Short-term therapeutic response was measured for at least 2 weeks after the start of therapy. Responders were defined with >50% headache reduction. Plasma CGRP concentrations were measured by ELISA. Results: In the migraine group, more patients required acute therapy, as compared to the NM group (62/68, 91% vs. 5/30, 15%, p = 0.001). The mean plasma CGRP level in migraineurs either during (291 ± 60 pg/ml) or between (240 ± 48) attacks was higher than in NM patients (51 ± 5 pg/ml, p = 0.006 and 0.018, respectively) and NH controls (53 ± 6 pg/ml, p = 0.016 and 0.045, respectively). Forty-seven patients (69%) needed preventive treatments and had higher plasma CGRP levels (364 ± 62 pg/ml, n = 47) than those not (183 ± 54 pg/ml, n = 21) (p = 0.031). Topiramate responders had higher plasma CGRP levels than non-responders (437 ± 131 pg/ml, n = 14 vs. 67 ± 19 pg/ml, n = 6, p = 0.021). Survival curves of plasma CGRP levels also showed those with higher CGRP levels responded better to topiramate. Differences were not found in the other preventives. Conclusion: The plasma CGRP level can differentiate migraine from non-migraine headache. It may also serve as a reference for the therapeutic strategy since it is higher in patients requiring migraine prevention and responsive to short-term topiramate treatment. These results are clinically significant, especially for the young children who cannot clearly describe their headache symptoms and may provide new insights into the clinical practice for the diagnosis and treatment of pediatric migraine.
Study site: Paediatric outpatient clinic,National Taiwan University Hospital (NTUH), Taiwan

Matched MeSH terms: Hospitals, University

Spontaneous tension or valvular pneumo-peritoneum

Chong TS

Journal of the Malaya Branch of the British Medical Association, 1937;1:78-80.

Matched MeSH terms: Hospitals

Ossification in a tendon sheath

Walkingshaw R

Journal of the Malaya Branch of the British Medical Association, 1939;2:252.

Matched MeSH terms: Hospitals

Fulltext Rheumatic heart disease in referred cases: Experience at a cardiology centre

Jamal F, Abdullah N, Zambahari R

Family Practitioner, 1988;11(1):46-47.

Matched MeSH terms: Hospitals, General

A case of concurrent leptospirosis and schistosomiasis in Malaya

Ryrie CA

Malayan Medical Journal, 1930;5:148-9.

Matched MeSH terms: Hospitals

A case of melioidosis

Lowson JMA, Luther S

Malayan Medical Journal, 1935;10:57.

Matched MeSH terms: Hospitals

A case of infantile pellagra in Malaya

Pallister RA

Journal of the Malaya Branch of the British Medical Association, 1940;4:110-3.

Matched MeSH terms: Hospitals

A prospective audit of Desflurane anaesthesia in the University of Malaya Medical Centre Day Surgery Unit

Chiu CL, Mansor M, Wang CY

JUMMEC, 2005;8:45-49.

We evaluated the use of Desflurane anaesthesia in this prospective observational audit in the University of Malaya Medical Centre Day Surgery Unit. Fifty ASA I-II unpremedicated day surgery patients received fentanyl and propofol induction after preoxygenation. Desflurane was introduced initially at 2% and the concentration was increased gradually to 4%, then 6%, 8% and 10% in nitrous oxide and oxygen. Patients breathed spontaneously throughout the surgery. Desflurane was switched off at the end of surgery and patients breathed 100% oxygen. The haemodynamic effect, perioperative complications and recovery profiles were recorded. Systolic arterial pressure and heart rate decreased after induction of anaesthesia but returned to baseline value at discharge. Adverse airway event such as coughing and postoperative nausea and vomiting are two unwanted complications. KEYWORDS: Desflurane, day surgery, propofol induction

Matched MeSH terms: Hospitals

Fulltext Setting up a pain clinic for cancer pain relief - the Cancer Pain Clinic

Delilkan AE

JUMMEC, 1999;4(2):65-66.

Matched MeSH terms: Hospitals, University

Fulltext Corticosteroid-related In-Hospital Hyperglycemia: Does It Negate Mortality Benefits in Coronavirus Disease 2019?

Kow CS, Hasan SS

Clin Infect Dis, 2021 11 02;73(9):e2848-e2849.

PMID: 32948881 DOI: 10.1093/cid/ciaa1423

Matched MeSH terms: Hospitals

Fulltext Transcatheter closure of patent ductus arteriosus: Our initial experience in University of Malaya Medical Centre

Zarin Ikmal ZZ, Wan Azman WM, Asma O, Mazeni A

JUMMEC, 2000;5:45-47.

Six patients underwent transcatheter closure of patent ductus arteriosus (PDA) using either conventional Gianturco coils or the Amplatzer Ductal Occluder (ADO) device. All patients were females with a median age of 23.3 (range 4 to 26 years). The mean PDA size measured on the lateral aortogram was 3.81mm (range 2.3-5.83mm). Complete closure of the PDA was achieved in all patients.

Matched MeSH terms: Hospitals

Fulltext A 15-year single centre retrospective study of antiphospholipid syndrome patients from Northern Malaysia

Islam MA, Alam F, Gan SH, Sasongko TH, Wan Ghazali WS, Wong KK

Malays J Pathol, 2017 08;39(2):123-133.

PMID: 28866693 MyJurnal

BACKGROUND: Antiphospholipid syndrome (APS) is an autoimmune disorder characterised by thrombosis and/or pregnancy morbidity in the presence of antiphospholipid antibodies (aPLs) based on the Sydney criteria. We aimed to explore the clinico-laboratory features and treatment strategies of APS patients retrospectively.
METHODOLOGY: The medical records of APS patients registered under Hospital Universiti Sains Malaysia (Kelantan state) between 2000 and 2015 were reviewed.
RESULTS: A total of 17 APS subjects (age 40.7 ± 12.8 years) including 11 primary (64.7%) and six secondary APS (35.3%) patients were identified. The follow-up period was 9.5 ± 6.7 years with male:female ratio of 1.0:4.7. Pregnancy morbidity was the most common clinical manifestation (11/14; 78.6%) followed by recurrent venous thrombosis (10/17; 58.8%). For other clinical features, menorrhagia was the most frequently observed manifestation (4/14; 28.6%) followed by aPLs-associated thrombocytopenia (4/17; 23.5%) and ovarian cyst (3/14; 21.4%). LA and aCL were positive in 94.1% (16/17) and 81.8% (9/11) of the patients, respectively. APTT value (76.7 ± 17.0 sec) was significantly high (p < 0.05). Low intensity warfarin alone was successful to maintain target INR (2.0 - 3.0) and prevent recurrence of thrombosis.
CONCLUSION: The tendency of pregnancy morbidity in this cohort of Malaysian Kelantanese APS patients was high compared to other previously reported APS cohorts. Low intensity warfarin was successful in preventing recurrence of thrombosis, however, APS women receiving long-term anticoagulants should be monitored for possible occurrence of menorrhagia and ovarian cysts.

Matched MeSH terms: Hospitals, University

Fulltext Comparison of the treatment practice and hospitalization cost of percutaneous coronary intervention between a teaching hospital and a general hospital in Malaysia: A cross sectional study

Lee KY, Wan Ahmad WA, Low EV, Liau SY, Anchah L, Hamzah S, et al.

PLoS One, 2017;12(9):e0184410.

PMID: 28873473 DOI: 10.1371/journal.pone.0184410

INTRODUCTION: The increasing disease burden of coronary artery disease (CAD) calls for sustainable cardiac service. Teaching hospitals and general hospitals in Malaysia are main providers of percutaneous coronary intervention (PCI), a common treatment for CAD. Few studies have analyzed the contemporary data on local cardiac facilities. Service expansion and budget allocation require cost evidence from various providers. We aim to compare the patient characteristics, procedural outcomes, and cost profile between a teaching hospital (TH) and a general hospital (GH).

METHODS: This cross-sectional study was conducted from the healthcare providers' perspective from January 1st to June 30th 2014. TH is a university teaching hospital in the capital city, while GH is a state-level general hospital. Both are government-funded cardiac referral centers. Clinical data was extracted from a national cardiac registry. Cost data was collected using mixed method of top-down and bottom-up approaches. Total hospitalization cost per PCI patient was summed up from the costs of ward admission and cardiac catheterization laboratory utilization. Clinical characteristics were compared with chi-square and independent t-test, while hospitalization length and cost were analyzed using Mann-Whitney test.

RESULTS: The mean hospitalization cost was RM 12,117 (USD 3,366) at GH and RM 16,289 (USD 4,525) at TH. The higher cost at TH can be attributed to worse patients' comorbidities and cardiac status. In contrast, GH recorded a lower mean length of stay as more patients had same-day discharge, resulting in 29% reduction in mean cost of admission compared to TH. For both hospitals, PCI consumables accounted for the biggest proportion of total cost.

CONCLUSIONS: The high PCI consumables cost highlighted the importance of cost-effective purchasing mechanism. Findings on the heterogeneity of the patients, treatment practice and hospitalization cost between TH and GH are vital for formulation of cost-saving strategies to ensure sustainable and equitable cardiac service in Malaysia.

Matched MeSH terms: Hospitals, General/economics*; Hospitals, Teaching/economics*

Displaying publications 201 - 220 of 2927 in total