MyMedR

Fulltext SMA Lecture: Ethical consequences of technological change

Rajakumar MK

Singapore Med J, 1984 Feb;25(1):1-5.

Dr Rajakumar delivered this lecture at the 14th SMA National Medical Convention on 16.4.1983
Republished in: Republished in: Teng CL, Khoo EM, Ng CJ (editors). Family Medicine, Healthcare and Society: Essays by Dr M K Rajakumar, Second Edition. Kuala Lumpur: Academy of Family Physicians of Malaysia, 2019: 83-90

A profile of certain infections in Malaysia

Kutty MK

Southeast Asian J Trop Med Public Health, 1978 Jun;9(2):244-6.

PMID: 725657

Solitary pulmonary cryptococcoma

Kutty MK

Southeast Asian J Trop Med Public Health, 1971 Mar;2(1):87.

PMID: 5112349

Fulltext A fatal case of pulmonary chromobacterium violaceum infection in an adult

Cheong BM

Med J Malaysia, 2010 Jun;65(2):148-9.

PMID: 23756802 MyJurnal

Chromobacterium violaceum is a gram negative, facultative anaerobic coccobacillus. Human infections are rare and usually occur after exposure to contaminated soil or water. Infections can present with fulminant septicemia, multiple abscesses and rapidly spreading soft tissue infections. Here we present a fatal case of pulmonary Chromobacterium violaceum infection following aspiration of drain water. Treatment with fluroquinolones in combination with either co-trimoxazole or amikacin has been described in successfully treated cases.

Fulltext Typhoid fever presenting as acute cerebellar ataxia and severe thrombocytopenia

Cheong BM

Med J Malaysia, 2008 Mar;63(1):77-8.

PMID: 18935745 MyJurnal

Typhoid fever being a systemic infection can present in a multitude of ways, involving various systems. Here we describe a case of typhoid fever presenting with acute cerebellar ataxia and marked thrombocytopenia. This atypical presentation is not common in typhoid fever and can lead to misdiagnosis as well as a delay in the initiation of appropriate therapy. Prompt clinical improvement and the return of platelet counts to normal were noted after the patient was started on IV Ceftriaxone.

Fulltext Early central nervous system involvement in a young patient with dengue encephalitis

Alice V, Cheong BM

Med J Malaysia, 2016 02;71(1):41-3.

PMID: 27130747

A previously well 13-year-old boy presented with a short history of fever and altered mental status. His mother was admitted for dengue fever and there had been a recent dengue outbreak in their neighbourhood. He was diagnosed with dengue encephalitis as both his dengue non-structural protein 1 (NS-1) antigen and cerebrospinal fluid (CSF) dengue polymerase chain reaction (PCR) were positive. He did not have haemoconcentration, thrombocytopenia or any warning signs associated with severe dengue. He recovered fully with supportive treatment. This case highlights the importance of considering the diagnosis of dengue encephalitis in patients from dengue endemic areas presenting with an acute febrile illness and neurological symptoms.

Fulltext The effect of piroxicam in preventing surgically induced miosis

Au MK, Singh P

Med J Malaysia, 1991 Dec;46(4):329-32.

PMID: 1840440

The effect of an antiprostaglandin, piroxicam, in preventing surgically induced miosis is studied. Patients undergoing extracapsular cataract surgery were randomly divided into the piroxicam and placebo groups. Intra-operative measurements of the pupillary diameters were performed. The stages of procedure at which they were measured were at the beginning of operation (Stage 1), after anterior capsulotomy (Stage 2), after lens nucleus delivery (Stage 3) and at the end of irrigation and aspiration (Stage 4). It is noted in this Study that the pupillary diameters were larger at stages 2,3 and 4 in the piroxicam group. The increase in the mean pupillary areas of the piroxicam group were statistically significant for Stages 3 and 4.

Maduramycosis in a Chinese in West Malaysia

Kutty MK, Bau K

Med J Malaya, 1969 Dec;24(2):151-3.

PMID: 4244142

Carcinoma of he stomach, colon, and rectum. A survey of 772 surgical biopsies from Malaya

King M, Kutty MK

Br J Surg, 1971 Feb;58(2):123-6.

PMID: 5548502

Fulltext Validity and Reliability of the Malay Version of the Identification of Functional Ankle Instability (IdFAI-M) Questionnaire among Malaysian University Athletes

Omar MK, Abdul-Karim S

Malays Orthop J, 2021 Mar;15(1):32-42.

PMID: 33880146 DOI: 10.5704/MOJ.2103.006

Introduction: This study was designed to produce a validated and reliable Malay version of the Identification of Functional Ankle Instability (IdFAI-M) questionnaire.

Materials and method: The cross-cultural adaptation was conducted based on standard guidelines to produce the Malay version of the Identification of Functional Ankle Instability (IdFAI-M) questionnaire. The reliability and validity testing were then performed among one hundred and twenty-three physically active University of Malaya students. Among them, twenty-two students also participated in the second return of the questionnaire over a two-week interval, which was then evaluated for test-retest reliability testing.

Results: The content validity for item-level (I-CVI) and Kappa values for all items were more than 0.7, respectively and the all scales-level (S-CVI) values were 0.983 (consistency), 0.967 (representativeness), 1.00 (relevance) and 0.983 (clarity). The questionnaire also demonstrated excellent reliability with an intraclass correlation coefficient (ICC2.1) above 0.850 for all items. It was observed that outer loading of most items were more than the minimum acceptable value (0.7). Fornell-Larcker criterion demonstrate all values for each reflective construct was larger than the correlations with other constructs, indicating discriminant. The cross-loading values of each item has shown a weak correlation with all other constructs, except for the one to which it was theoretically associated.

Conclusions: The Malay version of the IdFAI (IdFAI-M) is a reliable and valid instrument that can be readily utilised to subjectively assess ankle instability.

Malignant tumours in west Malaysia

Kutty MK, Balasegaram M

J R Coll Surg Edinb, 1972 Mar;17(2):102-7.

PMID: 5021743

Primary middle ear tuberculosis mimicking cholesteatoma

Aziz A, Md Daud MK

Malays Fam Physician, 2020;15(1):44-46.

PMID: 32284804

Tuberculous granuloma in the middle ear is an unusual entity. Herein, we report a case with short presentation of otitis media with mastoid abscess but with a CT scan showing widespread bone destruction. The cause was determined to be middle ear tuberculosis. Awareness of this entity is important, as it may cause a delay in referral to an otorhinolaryngology specialist and, subsequently, a delay in initiating treatment. Therefore, it should be considered in the differential diagnosis, especially when the usual treatment fails to produce the desired result.

Fulltext Developing and prototyping of empty fruit bunch high density board

J. Sahari, Shah, M. K. M, Nuratiqah, M.N., Rao, M.M.

Journal of Advanced Research Design, 2014;3(1):1-8.

MyJurnal

Empty fruit bunches and wastepaper together with urea formaldehyde (UF) were
evaluated to figure out potential applications in engineering field. The purpose of this project is to
determine the mechanical properties of a new high density board. This composite was manufactured
by hot-press technique with 3 different ratios i.e. 10:0, 6.67:3.33 and 9.33:0.67. The mechanical
properties were evaluated using the GOTECH/AI-7000M Electronic Mechanical Testing. Tensile tests
were carried out according to ASTM D638. The results were analysed to calculate the tensile
strength. Tensile strength at break ranged from 4.712 N/mm2 to 12.941 N/mm2 while hardness
number obtained ranged from 6.76 RHN to 75.84 RHN. This fibreboard has better properties when
reinforced with wastepaper compared to that of 100% empty fruit bunches. It is also found that the
hardness number is higher, which means that this fibreboard can withstand any load not more than
75.84 RHN. Finally, through Scanning Electron Microscope (SEM), the surface structure of the new
high density board has been studied in terms of their surface morphology.

Fulltext Wonders of halal and balanced, diet’ instructions

Norhaslinda, R., Adzim, M. K. R., Norhayati, A. H.

Asian Journal of Medicine and Biomedicine, 2018;1(1):23-27.

MyJurnal

Food defined as material that can be brought into the body of a human, animal or plant sources for
upholding the balance of life and it includes rice, vegetables, bread and others. However, in Islam, its
emphasized more on clean, harmless food and also with a code known as Halal diet. Halal is a term from
the Quran which means permissible or lawful. In Islam, known special regulations in the slaughter of
animals to be Halal diet include with saying the name of Allah the Almighty and make an incision to cut
the lifeblood of the animal's neck, letting the action veins and organs intact. In contrast, Haram means 'not
allowed' or 'forbidden' in Islam. Among the Haram foods as mentioned in the Qur'an and the Sunnah, it
includes carrion, blood, dogs, pigs, and alcohol.

Fulltext Protection by tocotrienols against hypercholesterolaemia and atheroma.

Teoh MK, Chong JMK, Mohamed J, Phang KS

Med J Malaysia, 1994 Sep;49(3):255-62.

PMID: 7845276

Antioxidants such as tocotrienols may protect against atherosclerosis since tissue injury from free radicals is a final common pathway of damage in arterial disease. In this study, the effects of tocotrienols on serum cholesterol, lipid peroxides, and aorta atheroma were assessed in rabbits fed an atherogenic diet for 12 weeks. Tocotrienols were more effective than tocopherols in preventing increases in serum LDL (p = 0.03) and total cholesterol (p = 0.008) levels in the cholesterol-fed rabbits. Elevation of serum lipid peroxides was effectively suppressed by tocotrienols (p = 0.01). Both tocopherols and tocotrienols offered significant protection against atheroma in the rabbit aorta, but tocotrienols had a stronger hypolipidaemic effect.
Comment in: Pathmanathan R, Wong KT. Protection by tocotrienols against hypercholesterolaemia and atheroma. Med J Malaysia. 1995 Mar;50(1):117

Fulltext Partial deletion 9p syndrome in Malaysian children

Chew HB, Thong MK

Med J Malaysia, 2010 Sep;65(3):215-7.

PMID: 21939171 MyJurnal

We report the first two Malaysian children with partial deletion 9p syndrome, a well delineated but rare clinical entity. Both patients had trigonocephaly, arching eyebrows, anteverted nares, long philtrum, abnormal ear lobules, congenital heart lesions and digital anomalies. In addition, the first patient had underdeveloped female genitalia and anterior anus. The second patient had hypocalcaemia and high arched palate and was initially diagnosed with DiGeorge syndrome. Chromosomal analysis revealed a partial deletion at the short arm of chromosome 9. Karyotyping should be performed in patients with craniostenosis and multiple abnormalities as an early syndromic diagnosis confers prognostic, counselling and management implications.

Fulltext Automatic top loader washing machine related injury. A report of four cases with serious injury

Kwan MK, Saw A, Sara Ahmad T

Med J Malaysia, 2005 Mar;60(1):112-4.

PMID: 16250295 MyJurnal

We are reporting four cases of serious washing machine related injury that presented within a period of 5 months. All patients were young children with the mean age of 9 year-old and three had their dominant hand injured. The washing machines involved were the automatic top loader type and all injuries occurred during the spinning phase. Serious automatic washing machine injury is not uncommon in Malaysia. We feel that there is a need to improve the safety features especially during the spinning phase. The operating instructions and safety precautions on the washing machine should be displayed in different languages that can be understood well. Parents should also aware of the potential risks of this seemingly benign household appliance.

Fulltext Treatment for flexion contracture of the knee during Ilizarov reconstruction of tibia with passive knee extension splint

Kwan MK, Penafort R, Saw A

Med J Malaysia, 2004 Dec;59 Suppl F:39-41.

PMID: 15941159

Joint stiffness is one of the complications of limb procedure. It developes as a result of failure of knee flexors to lengthen in tandem with the bone, especially when there is inadequate physical therapy to provide active and passive mobilization of the affected joint. We are reporting four patients who developed fixed flexion contracture of their knees during bone lengthening procedure for the tibia with Ilizarov external fixator. Three of them were treated for congenital pseudoarthrosis and one was for fibular hemimelia. None of them were able to visit the physiotherapist even on a weekly basis. A splint was constructed from components of Ilizarov external fixator and applied on to the existing frame to passively extend the affected knee. Patients and their family members were taught to perform this exercise regularly and eventually near complete correction were achieved. With this result, we would like to recommend the use of this "Passive Knee Extension Splint" to avoid knee flexion Contracture during limb lengthening procedures with Ilizarov external fixators.

Fulltext Sharing a microbe with man's best friend: A case of canine streptococcal infection in a diabetic patient

Cheong BM, Lim AY

Med J Malaysia, 2015 Oct;70(5):318-9.

PMID: 26556125

We report a case of a diabetic patient with an infected leg wound leading to septicemia and abscess formation in the contra-lateral leg due to Streptococcus canis. This organism belongs to the Lancefield group G and is more commonly found in dogs. It is often mistaken for Streptococcus dysgalactiae which is a human strain of streptococci. Infections in humans are not common and usually involve infected wounds or ulcers and the surrounding soft tissue. In most reported cases, patients had close contact with domestic dogs and a pre-existing wound as a portal of entry. Our patient recovered after surgical debridement and drainage of abscess together with antibiotics. This organism is sensitive to common antibiotics like penicillin, amoxycillin, cephalosporins and erythromycin. The incidence of infections due to Streptococcus canis may be under-reported as laboratories may just report an isolate as group G streptococcus. Susceptible patients with wounds or ulcers should be counselled on proper wound care and advised to avoid or minimise contact with the family dog.
Study site: Hospital Raja Permaisuri Bainun, Ipoh, Perak

Is there an optimal upper instrumented vertebra (UIV) tilt angle to prevent post-operative shoulder imbalance and neck tilt in Lenke 1 and 2 adolescent idiopathic scoliosis (AIS) patients?

Kwan MK, Chan CY

Eur Spine J, 2016 10;25(10):3065-3074.

PMID: 27021616

PURPOSE: To investigate whether an optimal upper instrumented vertebra (UIV) tilt angle would prevent 'lateral' shoulder imbalance or neck tilt (with 'medial' shoulder imbalance) post-operatively.

METHODS: The mean follow-up for 60 AIS (Lenke 1 and Lenke 2) patients was 49.3 ± 8.4 months. Optimal UIV tilt angle was calculated from the cervical supine side bending radiographs. Lateral shoulder imbalance was graded using the clinical shoulder grading. The clinical neck tilt grading was as follows: Grade 0: no neck tilt, Grade 1: actively correctable neck tilt, Grade 2: neck tilt that cannot be corrected by active contraction and Grade 3: severe neck tilt with trapezial asymmetry >1 cm. T1 tilt, clavicle angle and cervical axis were measured. UIVDiff (difference between post-operative UIV tilt and pre-operative Optimal UIV tilt) and the reserve motion of the UIV were correlated with the outcome measures. Patients were assessed at 6 weeks and at final follow-up with a minimum follow-up duration of 24 months.

RESULTS: Among patients with grade 0 neck tilt, 88.2 % of patients had the UIV tilt angle within the reserve motion range. This percentage dropped to 75.0 % in patients with grade 1 neck tilt whereas in patients with grade 2 and grade 3 neck tilt, the percentage dropped further to 22.2 and 20.0 % (p = 0.000). The occurrence of grade 2 and 3 neck tilt when UIVDiff was <5°, 5-10° and >10° was 9.5, 50.0 and 100.0 %, respectively (p = 0.005). UIVDiff and T1 tilt had a positive and strong correlation (r2 = 0.618). However, UIVDiff had poor correlation with clavicle angle and the lateral shoulder imbalance.

CONCLUSION: An optimal UIV tilt might prevent neck tilt with 'medial' shoulder imbalance due to trapezial prominence and but not 'lateral' shoulder imbalance.

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