Colonic diverticula is observed in over 60% of the western population aged over 80 where up to 30% will eventually be symptomatic and may develop complications. The natural history and etiology of colonic diverticula have been well described. However, predictive indicators of complicated diverticular disease are not known thus preventing the prophylactic treatment of this subset of patients,. The aim of this study was to observe patients with complicated diverticular disease in order to identify common factors associated with recurrent complications. All hospital admissions from January 2005 to December 2008 for complications of diverticular disease were recruited. Using logistic regression, demographic data and factors such as clinical presentation, nature of complication, lifestyle, concomitant medical illness and medications that may be associated with recurrent episodes of complications were analyzed. A total of 121 patients were diagnosed with complicated diverticular disease during the study period with 24 patients having recurrent complications. Logistic regression analysis performed after controlling for confounders found active smoking (p=0.006) and alcohol consumption (p=0.036) along with underlying diabetes (p=0.031) and dyslipidemia (p=0.039) significantly associated with an increased risk of recurrent complications. We therefore concluded that smoking, alcohol consumption, diabetes mellitus and dyslipidemia are associated with recurrent complicated colonic diverticular disease. As these are modifiable risk factors, they should be sought for during the presentation of the first attack. Aggressive control of these factors will help in reducing the risk of recurrent complications.
Trauma is a major health problem in Malaysia. An understanding of the trauma epidemiology is important in developing a reliable trauma service. The aim of this study is to understand the pattern of trauma in our institution and to highlight the need for a dedicated trauma service. In this database, 142 cases were included. Majority were males (127, 89.4%). Most common injury types are motor vehicle accidents (87.3%) followed by falls (7.7%) and stabs (3.5%). Most Injury Severity Score (ISS) falls under moderate score with 38.7%. Mean Abbreviated Injury Score (AIS) was 3 with most involving the chest and 90% of the patients have injuries involving at least 2 regions. Average hospital length of stay (LOS) was 11.4 days ±11.5 SD; with most patients (71.8%) were discharged without permanent disability. The mortality rate was 9.2% with all having ISS>16. ISS found to be strongly related to longer hospital stay and worse outcome (0.59, p < 0.0001, 0.4, p < 0.0001). This data is equivalent to the compared registries from 4 different trauma centres. However, steps need to be taken to improve this database. In conclusion, this university hospital receives a reasonable load of trauma cases yearly which is equivalent with other trauma centres. The increasing trauma cases will benefit from an implementation of a dedicated trauma service. This trauma database needs more depth in its elements and better data handling to ensure a quality and complete registry.