MyMedR

Fulltext Intussusception as a complication of gastrostomy tube: a case report

Hussain M, Thambidorai CR

Med J Malaysia, 2000 Jun;55(2):271-2.

PMID: 19839160

A neurologically impaired child who had fundoplication and gastrostomy done for gastroesophageal at the age of three, presented two years later with intestinal obstruction. She underwent laparotomy and was found to have antegrade jejuno-jejunal intussusception. Intussusception is an unusual but recognised complication of gastrostomy tube placement.

Matched MeSH terms: Intussusception/diagnosis

Fulltext Rare combination of seven fractures in the same forearm and wrist

Pan KL, Masbah O, Razak M

Med J Malaysia, 2000 Jun;55(2):268-70.

PMID: 19839159

A rare combination of a segmental ulnar fracture with fracture dislocation of the head of the radius and intraarticular fracture of the distal radius concomitant with an ipsilateral scaphoid, lunate and coronoid process fractures is presented. The mechanism of injury could possibly be a tremendous impact on the outstretched hand with a dorsiflexed wrist, fracturing the carpal bones and the distal radius. Transmitted axial forces on the ulna in a pronating forearm resulted in the other fractures. To the best of our knowledge, no such case has been reported. Open reduction with screw fixation of the scaphoid, plating of the proximal ulna and Kirschner wiring of the distal radius and radial head dislocation were done.

Matched MeSH terms: Fractures, Bone/diagnosis

Fulltext The management of upper respiratory tract infections

Teng CL, Shajahan Y, Khoo EM, Nurjahan I, Leong KC, Yap TG

Med J Malaysia, 2001 Jun;56(2):260-6; quiz 267.

PMID: 11771093

Upper respiratory tract infections are the commonest reason for consultation in primary care. Group A beta-haemolytic Streptococcus (GABHS), the most important bacterial pathogen in this condition, can be cultured from about 30% of patients, more so in children than adults. Clinical features that are predictive of positive GABHS culture are absence of cough, fever, cervical adenopathy, tonsillar enlargement and tonsillar exudate. Use of a sore throat score can help in the detection of streptococcal throat infection. Symptomatic therapies which are useful include anticholinergic, antihistamine, decongestant, humified hot air and Vitamin C. Antibiotics are universally over-prescribed in this condition as a result of high patient expectation and faulty clinical decision making. Oral Penicillin V for 10 days is the drug of choice. Effective intervention to reduce inappropriate antibiotic prescription probably require a multifaceted approach targeted at both the patients and the prescribers.

Matched MeSH terms: Respiratory Tract Infections/diagnosis

Delays in thrombolytic therapy in acute myocardial infarction: an audit from the east coast of peninsular Malaysia

Loke YK, Hwang SL, Tan MH

Ann Acad Med Singap, 1997 May;26(3):285-9.

PMID: 9285018

The objectives of this study were to evaluate the time delays between the onset of symptoms and admission to hospital and provision of thrombolytic therapy in patients with suspected acute myocardial infarction; and to examine the accuracy of the clinical diagnosis and the therapeutic decision on thrombolysis in these patients. An observational study of 96 patients with suspected myocardial infarction was undertaken over a period of 15 months in the Coronary Care Unit of Hospital Kuala Terengganu. Seventy per cent of the patients arrived in the hospital within 6 hours of the onset of symptoms. After arrival in the emergency room, it took a median time of 85 minutes before the administration of thrombolytic therapy. Of the 67 patients who were given thrombolysis, 46 were treated within 6 hours of the onset of symptoms. About a quarter of patients said that they had delayed seeking treatment at the hospital. Treatment delays occurring in the hospital were mainly due to admission procedures as well as late diagnosis. Eighty-one patients had confirmed myocardial infarction of whom 59 received thrombolytic therapy. Eight patients receiving thrombolytic therapy had no confirmation of myocardial infarctions. Improvements in diagnostic accuracy and reduction of delays in the provision of thrombolytic therapy could be achieved by better training of health care staff as well as by further streamlining of admission procedures.

Matched MeSH terms: Myocardial Infarction/diagnosis

Fulltext 14C-urea breath test: a useful non-invasive test in the diagnosis of Helicobacter pylori infection

Goh KL, Parasakthi N, Peh SC, Ong KK

Med J Malaysia, 1995 Sep;50(3):208-11.

PMID: 8926896

Sixty-three breath samples were collected from patients who underwent a 14C-urea breath test. Following ingestion of a radiolabelled 14C-labelled urea solution, breath samples containing 14C-labelled carbon dioxide were trapped in a solution containing hyamine hydroxide. Samples were then counted in a liquid scintillation counter. Breath samples were collected at 2, 15, 20, 25 and 30 minutes following ingestion of the urea solution. The presence or absence of Helicobacter pylori (HP) infection was determined on the basis of endoscopic biopsy tests which included culture, histological examination, rapid urease test and a gram stain of a fresh tissue smear. Thirty-two HP positive and 31 HP negative samples were collected. The mean counts at 15, 20, 12 and 30 minutes time points were: 4413, 4458, 4109 and 3795 dpm respectively for the positive samples and 1275, 877, 690 and 565 dpm respectively for the negative samples. Based on a cutoff value (mean of the negative samples + 3 standard deviations) for every time point, HP positive and negative samples could be clearly differentiated giving a sensitivity and specificity of 100%. The 14C-urea breath test is a reliable and convenient diagnostic test for H. pylori.

Matched MeSH terms: Helicobacter Infections/diagnosis*

Simultaneous dislocations of the carpometacarpal and metacarpophalangeal joints of the thumb

Ibrahim S, Noor MA

Injury, 1993 May;24(5):343-4.

PMID: 8349349

Matched MeSH terms: Dislocations/diagnosis*

Specificity of Schneider's first rank symptoms for schizophrenia in Malay patients

Salleh MR

Psychopathology, 1992;25(4):199-203.

PMID: 1492143

The frequency of Schneider's first rank symptoms (FRS) was studied in 221 Malay patients with functional psychosis. The prevalence of FRS in schizophrenia was 26.7%. The most common symptoms were voice arguing, passivity phenomena and somatic passivity. In the absence of organic brain dysfunction, the specificity of FRS for schizophrenia was 87.8%, and their positive predictive value was 90.6%. These findings indicate that although FRS is not pathognomonic of schizophrenia, their presence should be regarded as strongly suggestive of schizophrenia in the absence of organic etiology. FRS do not however occur with sufficient frequency to have potential diagnostic in schizophrenia.

Matched MeSH terms: Schizophrenia/diagnosis*

Childhood deafness in Malaysia

Elango S, Chand RP, Purohit GN

Int J Pediatr Otorhinolaryngol, 1992 Jul;24(1):11-7.

PMID: 1399299

One hundred and fifty-five children with childhood deafness were examined over a period of 4 years in order to assess the aetiology of hearing disorder. In 21 (13%) children, deafness was a sequel of meningitis. Perinatal pathology accounted for 34 (22%) cases. The aetiology of deafness was unknown in 44 (28.4%) children. The percentage of unknown causes can be reduced if the deafness is detected early. Hearing loss was diagnosed only in 30 (19%) children by the age of 2 years. The early detection of deafness can be achieved by screening the high risk infants and educating the general practitioners and health assistants.

Matched MeSH terms: Deafness/diagnosis

Fulltext Acute myocardial injury: an entity of acute coronary syndromes

Daud MS, Khalid Y

Med J Malaysia, 1997 Jun;52(2):183-5.

PMID: 10968081

A 46-year-old Indian man was admitted with unstable angina (Braunwald's class IIIB1)--the chest pain at rest was associated with inferolateral ischaemia on the ECG at admission. His serial total creatine kinase levels were elevated but CKMB was not detected. Serial serum troponin T levels were significantly raised suggesting the presence of significant acute myocardial injury.

Matched MeSH terms: Cardiomyopathies/diagnosis*

Fulltext The use of gutta-percha point to locate the origin of facial sinus

Ngeow WC

Med J Malaysia, 1997 Jun;52(2):181-2.

PMID: 10968080

Infection from the wisdom teeth usually causes severe swelling at the region of the angle and body of the mandible. Occasionally, it tracts outward to form a cervicofacial sinus. This paper demonstrates the use of gutta-percha point to locate the origin of a cervicofacial sinus due to an asymptomatic impacted wisdom tooth. The advantage of using gutta-percha point is discussed.

Matched MeSH terms: Mandibular Diseases/diagnosis*

Fulltext Superselective mesenteric arterial branch cannulation for intraoperative identification of bleeding intestinal mucosal lesions

Mahadeven M, Samad SA, Leong KS

Med J Malaysia, 1994 Jun;49(2):192-4.

PMID: 8090105

The intraoperative localisation of small intestinal bleeding lesions identified at pre-operative angiography has always been difficult, resulting in extensive resections in doubtful cases. We report two patients in whom, at angiography, a small intestinal lesion was noted to be the cause of gastrointestinal haemorrhage. They then underwent superselective mesenteric arterial cannulation at a second angiographic procedure and were operated upon with the angiographic catheter left within the branch responsible for the bleeding. This superselective catheter placement facilitates precise localisation of the bleeding site intraoperatively, enabling limited segmental resection of bowel. Both patients have had no recurrent bleeding episodes.

Matched MeSH terms: Gastrointestinal Hemorrhage/diagnosis*

Fulltext Non-familial haemophagocytic lymphohistiocytosis in children

Hoh MC, Lin HP

Med J Malaysia, 1997 Jun;52(2):146-50.

PMID: 10968072

Haemophagocytic Lymphohistiocytosis (HLH) is a rare clinical illness with a high mortality. There are reported effective treatment and a favourable outcome if diagnosed early. Five cases of childhood non-familial HLH seen over a 3 year period in our hospital are presented. The diagnosis was not suspected in the referring hospitals even after a bone marrow biopsy examination in two cases. Delay in referral was between 2 weeks to 2 months. A viral trigger was detected in only two cases. There were two deaths. Cause of death in both cases were cytomegalovirus pneumonitis and disseminated intravascular coagulopathy. Respond to treatment was better if started earlier. One case spontaneously resolved. Earlier diagnosis will lead to prompt treatment and a better outcome.

Matched MeSH terms: Histiocytosis, Non-Langerhans-Cell/diagnosis*

Fulltext Breast cancer 100 years on--what we have learnt!

Forrest AP

Med J Malaysia, 1996 Mar;51(1):163-73; quiz 174.

PMID: 10968004

Matched MeSH terms: Breast Neoplasms/diagnosis*

Pure-tone audiometry and auditory brainstem responses in noise-induced deafness

Noorhassim I, Kaga K, Nishimura K

Am J Otolaryngol, 1996 1 1;17(1):31-5.

PMID: 8801813

PURPOSE: The objective of this study is to find the relationship between pure-tone audiometry results and the auditory brainstem response wave abnormalities.

SUBJECTS AND METHODS: The pure-tone audiometry (PTA) and auditory brainstem responses (ABRs) from 22 patients (44 ears) with diagnosed noise-induced permanent hearing loss were studied. Three indices of PTA were average thresholds of 0.5 kHz/, /1 kHz, and 2 kHz (PTA1); 2 kHz and 4 kHz (PTA2); and 4 kHz (PTA3) were subdivided into 3 thresholds of hearing. Their relationships with ABR results were analysed. The patterns of PTA from various groups of ABR wave patterns were studied.

RESULTS: In this study, the abnormal ABR wave patterns were detected in 72.7% of the ears. The ears with prolonged ABR wave latency, absent early waves, prolong interpeak wave I-V latency was 20.5%, 18.2%, and 21.1%, respectively. Normal ABRs were recorded in 27.3% of the ears despite marked thresholds elevation of the PTA at high frequencies. Other relationships between PTA results and ABR wave results were discussed.

CONCLUSION: There were relationships between severity of noise-induced hearing loss indicated by PTA and the patterns of ABR wave abnormalities among workers with noise-induced permanent hearing loss.

Matched MeSH terms: Hearing Loss, Noise-Induced/diagnosis*

Fulltext Diagnosis and management of blunt pancreatic trauma: a case report with review of the literature

Khan TF, Zahari A

Med J Malaysia, 1993 Jun;48(2):244-7.

PMID: 8350806

Details of a young logger who sustained a clean prevertebral transection of the pancreas to the left of the superior mesenteric vessels and a crush injury in segments 2 and 3 of the liver are presented. CT scan was not done but ultrasound scan revealed free intraperitoneal fluid and no comment was made about the pancreas. The pancreatic injury was discovered at laparotomy carried out 24 hours after admission and treated by resection.

Matched MeSH terms: Abdominal Injuries/diagnosis*

Fulltext Comparative study of plain-film radiographs of maxillary sinuses between radiologists and clinicians

Krishnan G

Med J Malaysia, 1992 Sep;47(3):190-3.

PMID: 1491644

Maxillary sinuses plain film radiographs of 59 patients were reviewed and reported by both clinicians or Radiologists at the University Hospital, Kuala Lumpur. There was agreement in 52 reports of the plain film radiographs however there was partial differences in about seven cases. This gave an impression that the ENT specialist and the Radiologist were both capable of reporting plain film radiographs of maxillary sinuses, even though the radiologist has no opportunity of doing detail clinical examination of the patient.

Matched MeSH terms: Maxillary Sinusitis/diagnosis

Bilateral ovarian cysts in a newborn: a case report

Lim CT, Wong KK, Yap YF, Sivanesaratnam V

Asia Oceania J Obstet Gynaecol, 1992 Mar;18(1):19-22.

PMID: 1627057

Large ovarian cysts in the fetus are uncommon. Ultrasonography has helped in the detection of these cysts antenatally and in the newborn female infant. A case of bilateral ovarian cysts in a newborn is presented. The choice of management between conservative measures and surgical approaches remains controversial.

Matched MeSH terms: Polycystic Ovary Syndrome/diagnosis

Fulltext Fetal heart sound analysis: a preliminary evaluation

Baskaran A, Sivalingam N

Med J Malaysia, 1996 Mar;51(1):64-7.

PMID: 10967981

The aim of this study, is to determine whether the fine characteristics of the fetal heart sounds could be used to identify intrauterine growth retarded fetuses. A preliminary evaluation, was conducted to compare these characteristics between intrauterine growth retarded fetuses and normal fetuses in the antenatal period after 36 weeks of gestation. Altogether, 7 IUGR fetuses were compared with 12 normal fetuses. An instrument named the Fetal Frequency Phonocardiogram was designed for this purpose. When connected to a personal computer and with a software programme specially written, the fetal heart sound characteristics were analysed. After detailed analysis, there were 3 significant differences between IUGR and normal fetuses, all of which gave a p-value of < 0.01. The frequency of the first heart sound was significantly higher in the IUGR fetuses compared to normal fetuses. The ratio of the amplitude of the first heart sound over the second heart sound was higher in the IUGR group. Finally, the ratio of the time between the first and second heart sound over the cardiac cycle was shorter in the IUGR fetuses. Fetal heart sound analysis, may provide a simple non-invasive method of detecting and monitoring fetuses at risk in the antenatal period.

Matched MeSH terms: Fetal Growth Retardation/diagnosis*

First case of Acanthamoeba keratitis in Malaysia

Kamel AG, Norazah A

Trans R Soc Trop Med Hyg, 1995 11 1;89(6):652.

PMID: 8594684

Matched MeSH terms: Acanthamoeba Keratitis/diagnosis*

Fulltext Lead poisoning in childhood

Nasir HM, Kassim MS, Malinee T, Khairul AM, Low BH

Med J Malaysia, 1993 Sep;48(3):361-3.

PMID: 8183154

We report here a case of lead poisoning in a 20 month old girl who presented with acute encephalopathy and status epilepticus. The major clues leading to the diagnosis were the occupational family history and dense lead lines on X-ray of the long bones. She showed evidence of neurological dysfunction in the initial phase, but she improved steadily, regaining her motor power partially and her vision, although some cognitive and language deficits were already evident. She will need long-term neurological assessment and evaluation to ascertain the extent of permanent brain damage.

Matched MeSH terms: Lead Poisoning/diagnosis*

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