MyMedR

Fulltext Contributing factors in non-union of the humeral shaft fracture and the results of treatments

Baba R, Razak M

Med J Malaysia, 1998 Sep;53 Suppl A:42-51.

Out of 218 fractures of humeral shaft treated in the department, 23 (10.5%) of them developed non-union. 14/23 (60.9%) fracture were located in middle third. Transverse (52.2%), short oblique (17.4%) and comminuted fracture (13.0%) constituted about 82% of all initial fracture pattern. Twelve cases (52.5%) were initially treated with hanging cast. Radial nerve palsy occurred in 4/23 (17.4%) of patient and all of them located at lower third of humerus and only one recovered after eight weeks of injury. Factors such as middle third comminuted opened fractures, soft tissue interposition, improper immobilization and poor patient compliance were found to be directly associated with the non-union. All non-unions healed following plating and bone grafting. Overall 17/23 patient (74%) had good results, 4/23 (17%) fair and 2/23 (9%) with poor functional results.

Quality of life among Malaysian patients with vitiligo

Wong SM, Baba R

Int J Dermatol, 2012 Feb;51(2):158-61.

PMID: 22250623 DOI: 10.1111/j.1365-4632.2011.04932.x

Vitiligo is a chronic disease and can have significant impairment on patients' quality of life (QoL). Studies have shown that limitations in QoL are similar in magnitude to patients with other chronic skin diseases like psoriasis. The objective of this study was to assess the quality of life (QoL) of patients with vitiligo attending the dermatology clinic of a tertiary hospital in Malaysia.
Study site: Dermatology clinic, Hospital Kuala Lumpur, Malaysia

Determination of melanin types and relative concentrations: an observational study using a non-invasive inverse skin reflectance analysis

Hani AF, Baba R, Shamsuddin N, Nugroho H

Int J Cosmet Sci, 2014 Oct;36(5):451-8.

PMID: 24925684 DOI: 10.1111/ics.12147

Melanin is a major skin colour pigment that is made up of eumelanin (the dark brown-black colour) and pheomelanin (the light red-yellow colour) pigments. Skin-whitening products typically contain depigmentation agents that reduce the level of pigmentation by changing the pheomelanin-eumelanin production. Similarly, in skin pigment treatment of skin disorders, the melanin production is managed accordingly. To assess and improve treatment efficacy, it is important to have a measurement tool that is capable of determining the melanin types objectively. So far, the efficacy assessment is subjective. In this study, an inverse skin reflectance pigmentation analysis system that determines eumelanin and pheomelanin content is developed and evaluated in an observational study involving 36 participants with skin photo type IV.

Fulltext Comorbidities associated with psoriasis - data from the malaysian psoriasis registry

Mazlin MB, Chang CC, Baba R

Med J Malaysia, 2012 Oct;67(5):518-21.

PMID: 23770870

All around the world, there is growing evidence of the association between psoriasis and comorbidities which increase the risk of cardiovascular disease. This study aims to determine the prevalence of various comorbidities among adult psoriasis patients in Malaysia. A cross-sectional study was conducted among patients in the Malaysian Psoriasis Registry from January 2007 to December 2008. A total of 2,267 adult patients with psoriasis from 13 dermatology centers were included. Prevalence of various comorbidities were: hypertension 25.9%, diabetes mellitus 17.7 %, dyslipidaemia 17.8%, overweight 33.2%, obesity 20.7%, ischaemic heart disease 5.8% and cerebrovascular disease 1.4%. These comorbidities were more prevalent in patients with psoriasis of late-onset and longer duration. Active screening of these comorbidities in all adult psoriasis patients is recommended.

Syringocystadenoma papilliferum in an unusual location beyond the head and neck region: a case report and review of literature

Yap FB, Lee BR, Baba R

Dermatol. Online J., 2010;16(10):4.

PMID: 21062598

A case of syringocystadenoma papilliferum with multiple papulonodules in a linear fashion located in an unusual location of the right lower abdomen is presented. The presence of a large tumor at the inferior pole raised the suspicion of malignant transformation and the presence of discharge from the lesions raised the possibility of necrosis. However, histopathological examination showed the classical features of syringocystadenoma papilliferum without malignant transformation or tumor necrosis. The patient refused to undergo surgical excision of the nodules and subsequently was lost to follow-up. This case illustrates the atypical location of a rare disease and adds to the differential diagnosis of linear verrucous lesions on the abdomen. Review of all the cases with syringocystadenoma papilliferum outside the head and neck region in the English literature showed only one case of syringocystadenoma papilliferum arising on the abdomen; our patient is the second reported case with the unique feature of linear arrangement of lesions.

Efficacy and safety of sodium hypochlorite (bleach) baths in patients with moderate to severe atopic dermatitis in Malaysia

Wong SM, Ng TG, Baba R

J Dermatol, 2013 Nov;40(11):874-80.

PMID: 24111816 DOI: 10.1111/1346-8138.12265

Staphylococcus aureus is frequently found in patients with atopic dermatitis (AD) and contributes to disease exacerbation. The objective of this study was to evaluate the efficacy and safety of bleach baths as an adjunctive treatment in AD patients. Patients between 2 and 30 years old with moderate to severe AD were enrolled in a prospective, randomized, placebo-controlled study. Patients soaked in diluted bleach or distilled water baths for 10 min, twice a week for 2 months. Efficacy assessments included the Eczema Area and Severity Index (EASI) scores and S. aureus density was determined using quantitative bacterial cultures. Patients in the treatment group showed significant reductions in EASI scores. A 41.9% reduction in S. aureus density from baseline was seen at 1 month further reducing to 53.3% at 2 months. Equal numbers of patients in both groups experienced mild side-effects. This study demonstrates that diluted bleach baths clinically improved AD in as little as 1 month. No patient withdrew from the treatment arm because of intolerance to the baths.

Fingerprint verification prediction model in hand dermatitis

Lee CK, Chang CC, Johor A, Othman P, Baba R

Int J Dermatol, 2015 Jul;54(7):765-70.

PMID: 25427962 DOI: 10.1111/ijd.12451

Hand dermatitis associated fingerprint changes is a significant problem and affects fingerprint verification processes. This study was done to develop a clinically useful prediction model for fingerprint verification in patients with hand dermatitis.

Cutaneous sporotrichosis: a six-year review of 19 cases in a tertiary referral center in Malaysia

Tang MM, Tang JJ, Gill P, Chang CC, Baba R

Int J Dermatol, 2012 Jun;51(6):702-8.

PMID: 22607289 DOI: 10.1111/j.1365-4632.2011.05229.x

Sporotrichosis is a subcutaneous fungal infection caused by a thermally dimorphic aerobic fungus, Sporothrix schenckii. It results from traumatic inoculation or contact with animals. Most cases were reported mainly in the tropics and subtropics.

Fulltext Delayed Granulomatous Reaction after Oral Piercing during Thaipusam

Wong SM, Tang JJ, Thevarajah S, Baba R

Ann Dermatol, 2012 Aug;24(3):355-7.

PMID: 22879723 DOI: 10.5021/ad.2012.24.3.355

Methotrexate toxicity presenting as ulcerated psoriatic plaques

Wong SM, Chong YT, Thevarajah S, Baba R

Australas J Dermatol, 2012 Feb;53(1):81-3.

PMID: 22309341 DOI: 10.1111/j.1440-0960.2011.00779.x

Methotrexate toxicity is known to cause erosions of existing psoriatic plaques, although rare. We describe two patients who developed painful ulcerated psoriatic plaques as an early presenting sign of methotrexate toxicity and review the risk factors associated with this manifestation.

Small-scale field trials of Bacillus sphaericus (strain 2362) formulations against Mansonia mosquitoes in Malaysia

Yap HH, Tan HT, Yahaya AM, Baba R, Chong NL

J Am Mosq Control Assoc, 1991 Mar;7(1):24-9.

PMID: 1675256

Five formulations of Bacillus sphaericus (strain 2362) including aqueous suspension BSP 1, BSP 2, technical powder ABG 6184, corncob granules ABG 6185 (potencies 2 x 10(10), 2 x 10(7), 9.5 x 10(10), 5 x 10(10), 5 x 10(10) spore/g, respectively) and wettable powder ABG 6232 (1,000 BS ITU/mg) were tested against laboratory-cultured late third/early fourth instar larvae of Mansonia uniformis in floating screened cages in small plots at swampy ditches on Penang Island, Malaysia. Mean dosage/response values at 90% mortality levels were 6.93, 95.32, 1.45, 11.92 and 2.86 liters or kg per ha, respectively, for the formulations tested. There were practically no residual effects for the formulations tested with larvae introduced at 48, 96, and 168 h post-treatment. In trials of BSP 1, ABG 6184 and ABG 6185 (1 liter or 1 kg per ha) against immature Mansonia spp. in impounded paddy field ditches, improved efficacy and residual effects were obtained with mean reductions of 93.1, 91.9 and 80.4% at days 3, 7 and 14 posttreatment, respectively.

Causes of mortality in patients with psoriasis in Malaysia - Evidence from the Malaysian Psoriasis Registry

Kwan Z, Yeoh CA, Mohd Affandi A, Alias FA, Hamid M, Baharum N, et al.

Med J Malaysia, 2015 Oct;70(5):273-7.

PMID: 26556114

BACKGROUND: Patients with severe psoriasis, namely those requiring phototherapy or systemic treatment, have an increased risk of death. The aim of this study was to determine the prevalence, aetiology and risk factors for mortality among adult patients aged 18 years and above with psoriasis in Malaysia.

METHODS: This was a retrospective study involving adult patients notified by dermatologists to the Malaysian Psoriasis Registry between July 2007 and December 2013. Data were cross-checked against the National Death Registry. Patients certified dead were identified and the cause of death was analysed. Multivariate analysis using multiple logistic regression were conducted on potential factors associated with higher risk of mortality.

RESULTS: A total of 419 deaths were identified among the 9775 patients notified. There were four significant risk factors for higher mortality: age>40 years (age 41-60 years old, Odds Ratio (OR) 2.70, 95%CI 1.75, 4.18; age>60 years OR 7.46, 95%CI 4.62, 12.02), male gender (OR 1.72, 95%CI 1.33,2.22), severe psoriasis with body surface area (BSA) >10% (OR 1.52, 95%CI 1.19, 1.96) and presence of at least one cardiovascular co-morbidity (OR 1.67, 95% CI 1.30, 2.14). Among the 301 patients with verifiable causes of death, the leading causes were infection (33.9%), cardiovascular disease (33.6%) and malignancy (15.9%).

CONCLUSION: Infection was the leading cause of death among psoriasis patients in Malaysia. Although cardiovascular diseases are well-known to cause significant morbidity and mortality among psoriasis patients, the role of infections and malignancy should not be overlooked.

Field efficacy of mosquito coil formulations containing d-allethrin and d-transallethrin against indoor mosquitos especially Culex quinquefasciatus Say

Yap HH, Tan HT, Yahaya AM, Baba R, Loh PY, Chong NL

Southeast Asian J Trop Med Public Health, 1990 Dec;21(4):558-63.

PMID: 2098916

Comparative field efficacy studies of four mosquito coil formulations containing active ingredient of d-allethrin (0.19 or 0.28 w/w) and d-transallethrin (0.12 or 0.16% w/w) and blank coils without active ingredient were carried out in living rooms (mean size 54.1 m3) of residential houses in a squatter area in Butterworth, Malaysia. The major indoor biting mosquitos collected in the test site were that of Culex quinquefasciatus Say (84.7%). Mean percentage reduction of blank coils, coils with 0.19 and 0.28% d-allethrin and coils with 0.12 and 0.16% d-transallethrin were 29.0, 71.7, 70.9, 75.0 and 72.6%, respectively. The use of coils as a mean of personal protection against mosquitos is discussed.

Fulltext South-East Asia study alliance guidelines on the management of acne vulgaris in South-East Asian patients

Goh CL, Abad-Casintahan F, Aw DC, Baba R, Chan LC, Hung NT, et al.

J Dermatol, 2015 Oct;42(10):945-53.

PMID: 26211507 DOI: 10.1111/1346-8138.12993

The management of acne in South-East Asia is unique, as Asian skin and local variables require a clinical approach unlike that utilized in other parts of the world. There are different treatment guidelines per country in the region, and a group of leading dermatologists from these countries convened to review these guidelines, discuss current practices and recent advances, and formulate consensus guidelines to harmonize the management of acne vulgaris in the region. Emphasis has been placed on formulating recommendations to impede the development of antibiotic resistance in Propionibacterium acnes. The group adopted the Acne Consensus Conference system for grading acne severity. The group recommends that patients may be treated with topical medications including retinoids, benzoyl peroxide (BPO), salicylic acid, a combination of retinoid and BPO, or a combination of retinoids and BPO with or without antibiotics for mild acne; topical retinoid with topical BPO and a oral antibiotic for moderate acne; and oral isotretinoin if the patient fails first-line treatment (a 6- or 8-week trial of combined oral antibiotics and topical retinoids with BPO) for severe acne. Maintenance acne treatment using topical retinoids with or without BPO is recommended. To prevent the development of antibiotic resistance, topical antibiotics should not be used as monotherapy or used simultaneously with oral antibiotics. Skin care, comprised of cleansing, moisturizing and sun protection, is likewise recommended. Patient education and good communication is recommended to improve adherence, and advice should be given about the characteristics of the skin care products patients should use.

Fulltext Towards global consensus on core outcomes for hidradenitis suppurativa research: an update from the HISTORIC consensus meetings I and II

Thorlacius L, Garg A, Ingram JR, Villumsen B, Theut Riis P, Gottlieb AB, et al.

Br J Dermatol, 2018 03;178(3):715-721.

PMID: 29080368 DOI: 10.1111/bjd.16093

BACKGROUND: A core outcomes set (COS) is an agreed minimum set of outcomes that should be measured and reported in all clinical trials for a specific condition. Hidradenitis suppurativa (HS) has no agreed-upon COS. A central aspect in the COS development process is to identify a set of candidate outcome domains from a long list of items. Our long list had been developed from patient interviews, a systematic review of the literature and a healthcare professional survey, and initial votes had been cast in two e-Delphi surveys. In this manuscript, we describe two in-person consensus meetings of Delphi participants designed to ensure an inclusive approach to generation of domains from related items.

OBJECTIVES: To consider which items from a long list of candidate items to exclude and which to cluster into outcome domains.

METHODS: The study used an international and multistakeholder approach, involving patients, dermatologists, surgeons, the pharmaceutical industry and medical regulators. The study format was a combination of formal presentations, small group work based on nominal group theory and a subsequent online confirmation survey.

RESULTS: Forty-one individuals from 13 countries and four continents participated. Nine items were excluded and there was consensus to propose seven domains: disease course, physical signs, HS-specific quality of life, satisfaction, symptoms, pain and global assessments.

CONCLUSIONS: The HISTORIC consensus meetings I and II will be followed by further e-Delphi rounds to finalize the core domain set, building on the work of the in-person consensus meetings.

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