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Displaying publications 381 - 400 of 1997 in total

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Fulltext A review of the acute pain service in Hospital Kuala Lumpur

Neelima G, Chieng DC, Lim TA, Inbasegaran K

Med J Malaysia, 2003 Jun;58(2):167-79.
PMID: 14569736 MyJurnal

This study is a review of the Acute Pain Service in Hospital Kuala Lumpur for the years 1998 to 2001. 5042 records from post-operative patients were analysed. The majority of patients (81.8%) had satisfactory pain control. Eighty-two percent of patients experienced only mild pain at rest on the first post-operative day. The highest pain score occurred on the first day in 68.3% of patients. Nausea or vomiting occurred in 23.2% of the patients. Eight patients had respiratory depression. The low pain scores recorded by most patients and the low incidence of side effects reflect the efficiency of the service provided.

Matched MeSH terms: Aged, 80 and over
Fulltext P53 protein expression in transitional cell carcinoma of the bladder - experience of the University of Malaya Medical Centre

Ong TA, Peh SC, Goh KSK, Naicker MS, Khan AF, Chua BC, et al.

Asian J Surg, 2003 Jan;26(1):31-6.
PMID: 12527492 DOI: 10.1016/S1015-9584(09)60212-8

To study the incidence of p53 oncoprotein overexpression and its relationship to tumour grade, stage and clinical prognosis in a cohort of local Malaysian patients.

Matched MeSH terms: Aged, 80 and over
Reliability and validity of the Malay version of the International Prostate Symptom Score in the Malaysian population

Quek KF, Low WY, Razack AH, Sin Loh C, Chua CB

J Urol, 2002 Mar;167(3):1359-62.
PMID: 11832732

PURPOSE: We validated the Malay version of the International Prostate Symptom Score in patients with and without urinary symptoms in the Malaysian population.
MATERIALS AND METHODS: Validity and reliability were studied in patients with and without lower urinary tract symptoms. Reliability was evaluated using the test-retest method and internal consistency was assessed by Cronbach's alpha. Sensitivity to change was expressed as the effect size in the pre-intervention versus post-intervention score in additional patients with lower urinary tract symptoms who underwent transurethral prostate resection.
RESULTS: Internal consistency was excellent. A high degree of internal consistency was observed for each of the 7 items and for the total score (Cronbach's alpha 0.53 and greater, and 0.68, respectively). The test-retest correlation coefficients of the 7 items were highly significant. The intraclass correlation coefficient was high at 0.51 and greater. There was a high degree of sensitivity and specificity to the effects of treatment. Significant change from baseline to posttreatment scores was observed in all 8 items in the treated but not in the control group.
CONCLUSIONS: The Malay International Prostate Symptom Score is a suitable, reliable, valid instrument that is sensitive to clinical change in the Malaysian population.

Matched MeSH terms: Aged, 80 and over
Community-acquired pneumonia in patients requiring hospitalization

Liam CK, Lim KH, Wong CM

Respirology, 2001 Sep;6(3):259-64.
PMID: 11555386

This study aimed to investigate the microbial aetiology of community-acquired pneumonia (CAP) in patients requiring hospitalization.

Matched MeSH terms: Aged, 80 and over
Intravesical explosion during transurethral resection of the prostate

Dublin N, Razack AH, Loh CS

ANZ J Surg, 2001 Jun;71(6):384-5.
PMID: 11409027
Matched MeSH terms: Aged, 80 and over
Reliability and validity of the International Prostate Symptom Score in a Malaysian population

Quek KF, Low WY, Razack AH, Loh CS

BJU Int, 2001 Jul;88(1):21-5.
PMID: 11446839

OBJECTIVE: To validate the English version of the International Prostate Symptom Score (IPSS) in patients with and without urinary symptoms in a Malaysian population.
PATIENTS AND METHODS: Validity and reliability were assessed in patients with lower urinary tract symptoms (LUTS) and in patients with no LUTS. Reliability was evaluated using the test-retest method and internal consistency using Cronbach's alpha. Sensitivity to change was expressed as the effect size in the score before and after intervention in additional patients with LUTS who underwent transurethral resection of the prostate (TURP).
RESULTS: Internal consistency was excellent; there was a high degree of internal consistency for each of the seven domains and for the total score (Cronbach's alpha > or = 0.60 and > or = 0.79, respectively) in the populations studied. The test-retest correlation coefficient for the seven domain scores was highly significant. The intra-class correlation coefficient was high (> or = 0.59). There was a high level of sensitivity and specificity for the effects of treatment, with a very significant change between the seven scores domains in the treated group but not in the control group.
CONCLUSIONS: The IPSS is suitable, reliable, valid and sensitive to clinical change in the Malaysian population.

Matched MeSH terms: Aged, 80 and over
Fulltext A study on community acquired pneumonia in adults requiring hospital admission in Penang

Hooi LN, Looi I, Ng AJ

Med J Malaysia, 2001 Sep;56(3):275-84.
PMID: 11732071

A study was carried out to determine the pattern of microbiological organisms causing community acquired pneumonia in adult patients admitted to Penang Hospital between November 1999 and August 2000. Altogether, 98 patients (64 males, 34 females) with a mean age (+/- S.D.) of 55.9 (+/- 19.0) (range 15 to 87) years were included in the study. Causative organisms were identified in 42 patients (42.9%). Mycobacterium tuberculosis was the commonest pathogen being identified in 15.3% of cases, followed by Klebsiella pneumoniae (7.2%), Pseudomonas aeruginosa (6.1%) and Staphylococcus aureus (5.1%). Streptococcus pneumoniae and Acinetobacter spp accounted for 3 cases each (3.1%) and Haemophilus influenzae, non-haemolytic Streptococcus, Mycoplasma pneumoniae, Salmonella typhi, Escherichia coli, Klebsiella spp and Pseudomonas spp for 1 case each (1.0%). Four patients (4.1%) had dual infections and no case of legionella pneumonia was found in this series.

Matched MeSH terms: Aged, 80 and over
Fulltext Hepatitis B surface antigen subtypes in hepatitis B seropositive subjects in University Hospital, Kuala Lumpur

Ng KP, Saw TL

Med J Malaysia, 1999 Sep;54(3):352-7.
PMID: 11045062

Hepatitis B surface antigen can be serologically defined as ayw1, ayw2, ayw3, ayw4, ayr, adw2, adw4 and adrq+ or adrq-. A study of common HBsAg subtypes in 44 HBsAg reactive sera in University Hospital was conducted using a solid-phase sandwich EIA. Eleven samples were found not typable and among the 33 typable HBsAg reactive sera, 3 HBsAg subtypes: adw, adr and ayw were identified. Subtype adw was found in 66.7% (22/33) of the typable HBsAg reactive sera; 24.2% (8/33) was of subtype adr and 6.0% (2/33) of subtype ayw. One sample was found to be reactive to both adw and adr. HBsAg subtype adw was found more commonly in Chinese but among the Malays, HBsAg subtype adr appeared to predominate. However, the small sample size precludes firm conclusions on the predominant subtype among the Malays.

Matched MeSH terms: Aged, 80 and over
Fulltext Revascularization for foot salvage in diabetic critical foot ischaemia

Yii MK, Liew NC

Med J Malaysia, 1999 Sep;54(3):325-8.
PMID: 11045058

A consecutive series of 32 diabetic patients, 16 male and 16 female, who presented to the authors with critical limb ischaemia was reviewed over a two-year period. Atherosclerotic risk factors and co-morbidities were present in 56% of these patients. Diagnostic angiography was performed in all patients. Revascularization was achieved in 91% of the cases with three perioperative deaths. Ten bypasses were anastomosed distally to one of the crural or ankle arteries at the foot. Major amputations were required in five patients who had had revascularization and in 4 of these gross sepsis was the main factor responsible for limb loss despite patent grafts. The primary graft patency rates at one month and one year were 96% and 90% respectively. Surgical reconstruction was possible in the majority of diabetic patients with critical ischaemia and should be offered to patients preferably before the establishment of gross sepsis to improve limb salvage.

Matched MeSH terms: Aged, 80 and over
Fulltext Use of the uroflow study in the diagnosis of bladder outlet obstruction in elderly men

Ding YY, Lieu PK, Choo PWJ

Med J Malaysia, 1998 Sep;53(3):209-16.
PMID: 10968155

The uroflow and pressure-flow data of 67 men aged 65 years or more were compared. At best, the uroflow study applying the Liverpool nomogram (25th percentile) and Bristol nomogram (OSD) diagnosed bladder outlet obstruction with sensitivity of 62.5% and 62.5% and specificity of 48.8% and 74.4% respectively. Using the 50th percentile of the Liverpool nomogram as the cut-off resulted in a negative predictive value of 100.0% allowing about 10% of men to have this diagnosis ruled out. We conclude that the uroflow study is inaccurate in diagnosing bladder outlet obstruction in elderly men. However, it can be used to rule out this condition in the small subset of men with maximum flow rates above the 50th percentile of the Liverpool nomogram.

Matched MeSH terms: Aged, 80 and over
Trends and ethnic differences in hospital admissions and mortality for congestive heart failure in the elderly in Singapore, 1991 to 1998

Ng TP, Niti M

Heart, 2003 Aug;89(8):865-70.
PMID: 12860859

To describe trends in hospital admissions and mortality from congestive heart failure in the elderly population aged 65 years and over in Singapore, 1991 to 1998.

Matched MeSH terms: Aged, 80 and over
Fulltext Pilot study of formestane in postmenopausal women with breast cancer

Joseph JK, Lim AKH

Med J Malaysia, 1998 Mar;53(1):37-41.
PMID: 10968135

A pilot study of Formestane or 4-Hydroxyandrostenedione (Lentaron), a new endocrine agent, was conducted on 18 postmenopausal patients with locally advanced and metastatic breast cancer. 16 patients were evaluable for response and objective responses were seen in 4 patients (25%). Stabilisation of disease was seen in 5 patients (32%). Out of 17 patients evaluable for toxicity, 3 (18%) reported adverse effects including hot flushes, lethargy and myalgia. Adverse effects were mild, transient and no patient required discontinuation of drug. Our study confirms that Formestane is a well tolerated endocrine agent with low toxicity and reasonable efficacy in postmenopausal patients with locally advanced and metastatic breast cancer.

Matched MeSH terms: Aged, 80 and over
Fulltext Experience in snuffbox arteriovenous fistulae for hemodialysis

Lee JK, Sara TT

Med J Malaysia, 2000 Sep;55 Suppl C:35-8.
PMID: 11200042

Sixty-five patients with "Snuffbox" arteriovenous fistulae for hemodialysis were reviewed. The procedure was performed under local anaesthesia as an outpatient procedure. It was done as a "standby" procedure for 41.5% of patients with Chronic Ambulatory Peritoneal Dialysis. 58.5% of patients had the procedure done for primary hemodialysis. Patency was assessed as presence of an engorged vein and presence of thrill. This was assessed routinely at 4 to 6 weeks after the procedure. Patency rate was noted to be 83%. The commonest complication was thrombosis of the arteriovenous anastomosis. Some patients required repeated procedure at a more proximal site. Further study to determine the blood flow rate provided by the anastomosis, and comparison with other anatomical sites is necessary.

Matched MeSH terms: Aged, 80 and over
Fulltext Pattern of lymph node pathology in a private pathology laboratory

Kim LH, Peh SC, Chan KS, Chai SP

Malays J Pathol, 1999 Dec;21(2):87-93.
PMID: 11068412

Lymph node excision biopsy is commonly carried out for the investigation of lymphadenopathy. The objective of this study is to elucidate the pattern of nodal pathology seen in a private pathology practice. A total of 137 nodal biopsies for primary investigation of nodal enlargement were retrieved from the files in a private diagnostic pathology laboratory in the year 1997. Lymph nodes excised for cancer staging were excluded from this study. The histology was reviewed based on H&E stained sections, and with additional histochemical and immunoperoxidase stains when deemed necessary. Cases of malignant lymphomas were sub-classified with the aid of further immunophenotyping using a panel of monoclonal and polyclonal lymphoid antibodies. One case was excluded from this study due to inadequate tissue for further assessment. There were 58 males and 78 females, giving a ratio of 1:1.3 in the remaining 136 cases. They consisted of 13 Malays (M), 108 Chinese (C), 14 Indians (I) and 1 other ethnic group (O). The ratio of M:C:I:O was 1:8.3:1.1:0.1. The majority of the cases were in the age range of 20 to 50 years. The pathology consisted of 17 (12.5%) malignant lymphomas [6 Hodgkin's lymphoma, 11 non-Hodgkin's lymphoma], 35 (25.7%) metastatic carcinomas, 45 (33.1%) reactive hyperplasia, 19 (13.9%) tuberculosis, 11 (8.2%) Kikuchi's disease and 9 (6.6%) others (Castleman's disease 2, cat scratch disease 2, Kimura's disease 1, sarcoidosis 1, non-specific lymphadenitis 3). All categories of nodal disease showed approximately similar ratio of ethnic and gender distribution as above, except for Kikuchi's disease, for which 100% of the patients were female. The most common site of biopsy was from the head and neck region, particularly the cervical group of nodes. The most common nodal pathology seen in the private laboratory was reactive hyperplasia, followed by metastatic carcinoma. Malignant lymphoma constituted only 12.5% of the cases.

Matched MeSH terms: Aged, 80 and over
The psychological effects of treatments for lower urinary tract symptoms

Quek KF, Low WY, Razack AH, Loh CS

BJU Int, 2000 Oct;86(6):630-3.
PMID: 11069367

OBJECTIVE: To assess and evaluate the level of depression, anxiety and psychiatric status in patients with lower urinary tract symptoms (LUTS) before and after treatment by surgery or drugs.
PATIENTS AND METHODS: The study included 123 patients (mean age 64.6 years, SD 7. 95) with LUTS who were treated medically (with alpha-blockers, i.e. terazosin, prazosin, doxazosin and alfuzosin), and 52 patients (mean age 69.6 years, SD 7.94) with LUTS and confirmed to have benign prostatic hyperplasia (BPH) who underwent transurethral resection of the prostate (TURP). Both groups were assessed at baseline and 3 months after treatment using standardized questionnaires (the Beck Depression Inventory, the State-Trait Anxiety Inventory and the General Health Questionnaire-12).
RESULTS: Patients before TURP were significantly more depressed, worried and psychiatrically morbid than were those before medical treatment. Three months after medical and surgical treatment, there was significantly less depression, anxiety and psychiatric morbidity in the TURP than in the medication group.
CONCLUSIONS: TURP is a better treatment than medication for minimising anxiety, depression and psychiatric morbidity after treatment in patients with LUTS, but causes greater psychological stress before treatment.

Matched MeSH terms: Aged, 80 and over
Malignant proliferating trichilemmal tumour: a case report

Fernandez SH

Malays J Pathol, 1999 Dec;21(2):117-21.
PMID: 11068417

An 86-year-old man presented with a painless, pea-sized growth over the left angle of his jaw, which had been gradually enlarging over two years. A clinical diagnosis of pilar cyst was made. Histopathological examination of the mass revealed a malignant proliferating trichilemmal tumour. During follow-up 4 months later, a palpable small upper jugular lymph node was noted at the left side of the neck. Biopsy revealed a metastatic malignant trichilemmal tumour. This case illustrates a rare malignant tumour which is a challenge to clinical diagnosis.

Matched MeSH terms: Aged, 80 and over
Fulltext Peak expiratory flow rate in elderly Malaysians

Srinivas P, Chia YC, Poi PJH, Ebrahim S

Med J Malaysia, 1999 Mar;54(1):11-21.
PMID: 10971999

An epidemiological survey was conducted among 1,414 healthy ambulatory elderly persons aged 55 years and above in the Kuala Langat district, Selangor. The relationship between peak expiratory flow rate (PEFR), demographic variables, socioeconomic status, smoking, alcohol use and respiratory symptoms were examined. The peak expiratory flow declined with age and were lower in women of all ages. Smoking had a modest effect on PEFR in men but not on PEFR in women. The combination of respiratory symptoms of cough, phlegm and wheeze were related to lower PEFR values. Prediction equations are presented derived from the population sample which may be of assistance in assessing observed to expected ratios among elderly people in Malaysia.

Matched MeSH terms: Aged, 80 and over
Fulltext Pressure ulcers--randomised controlled trial comparing hydrocolloid and saline gauze dressings

Chang KW, Alsagoff S, Ong KT, Sim PH

Med J Malaysia, 1998 Dec;53(4):428-31.
PMID: 10971989

An open comparative randomised study comparing the performance of hydrocolloid dressings (DuoDERM CGF) to saline gauze dressings in the treatment of pressure ulcers was done to evaluate the overall dressing performance, wound healing and cost effectiveness. Thirty-four subjects were enrolled at the University Hospital, Kuala Lumpur over a 643 days period. Inclusion criteria were Stage II or III pressure ulcers, at least 18 years of age and written informed consent. Only one pressure ulcer per subject was enrolled in the study. Patients with infected pressure ulcers, diabetes mellitus, an immuno-compromised status and known sensitivity to the study dressings were excluded. Subjects who met the enrollment criteria were randomised to one of the two dressing regimes. They were expected to participate in the study for a maximum of eight weeks or until the pressure ulcer healed, which ever occurred first. Overall subject age averaged 58 years and the mean duration of pressure ulcer existence was about 1 month. Twenty-one of the thirty-four ulcers enrolled were stage II and thirteen were stage III. The majority of the ulcers (88%) were located in the sacral area and seventeen subjects (50%) were incontinent. In the evaluation of dressing performance in terms of adherence to wound bed, exudate handling ability, overall comfort and pain during dressing removal; all favoured the hydrocolloid dressing by a statistically significant margin (p < 0.001). Subjects assigned the hydrocolloid dressing experienced a mean 34% reduction from their baseline surface area measurement compared to a mean 9% increase by subjects assigned gauze dressings. This was not statistically significant (p = 0.2318). In cost evaluation of the study products, there was no statistical significance in the total cost of wound management per subject. When only labour time and cost was evaluated, there was a statistically significant advantage towards hydrocolloid dressings.

Matched MeSH terms: Aged, 80 and over
Fulltext Profile of patients with abdominal aortic aneurysm referred to the Vascular Unit, Hospital Kuala Lumpur

Zainal AA, Yusha AW

Med J Malaysia, 1998 Dec;53(4):423-7.
PMID: 10971988

A prospective collection of patients referred with a diagnosis of abdominal aortic aneurysm (AAA) to the Vascular Unit, Hospital Kuala Lumpur (HKL) between February 1993 to July 1995 were analysed. There were a total of 124 patients, with a 85 per cent (%) male preponderance. Malays formed the largest ethnic group contributing about 60%. The median age of the patients was 69 years (range 49-84). Emergency referrals and admission accounted for 46.8% of patients. Hypertension and ischaemic heart disease were the two most common co-morbid medical conditions. The number of patients who underwent surgery was only 56 (45.2%). Of this total, 34 were done electively with an operative mortality of 8.8% (3 pts). The operative mortality for emergency surgery was 59.1%. AAA is relatively common in the older age group, especially in men and it should be actively looked for, as elective surgery can be offered with acceptable morbidity and mortality.

Matched MeSH terms: Aged, 80 and over
A study of mean glandular dose during diagnostic mammography in Malaysia and some of the factors affecting it

Jamal N, Ng KH, McLean D

Br J Radiol, 2003 Apr;76(904):238-45.
PMID: 12711643

The primary objective of this study was to determine the mean glandular dose (MGD) during diagnostic mammography in Malaysia. The secondary objective was to evaluate some of the factors affecting MGD. A survey of standard MGD was performed, based upon quality control records for the period October 1999 to August 2001. This covered 30 mammography units from 9 manufacturers. MGD was also measured for a series of patients attending mammography examinations at three other mammography units. MGD per film was estimated from recorded radiographic factors, the compressed breast thickness (CBT) and X-ray unit calibration data. MGD per woman was calculated by summing the MGDs for all films, and averaging it over both breasts. 300 women drawn equally from three major ethnic groups, namely Malay, Chinese and Indian, took part in the study. The difference of MGD per woman between ethnic groups was tested for significance using non-parametric Kruskal-Wallis and median tests. The factors affecting MGD per woman were tested for significance using a multivariate analysis of variance. The MGD for the phantom was 1.23 mGy (range 0.22-2.39 mGy) while the mean patient based MGD per film was 1.54 mGy and 1.82 mGy for the craniocaudal and mediolateral oblique views, respectively. The mean MGD per woman was 3.37 mGy. It was also found that there is no significant difference in MGD per woman among the ethnic groups (p>0.05, Kruskal-Wallis test). However, on the multivariate test two factors, namely half value layer of the X-ray beam and (CBT), had a significant effect on MGD per woman (p<0.05). No significant relationships were seen between MGD per woman with respect to ethnicity, body mass index or age.

Matched MeSH terms: Aged, 80 and over

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