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Fulltext Outbreak of pneumonia in an army recruit training centre, Port Dickson, Negeri Sembilan, July-August, 2000

Mohamed Paid, Y., Muhammad Amir, K., Mustafa Bakri, A., Low, S.H.

Malaysian Journal of Public Health Medicine, 2004;4(1):35-0.
MyJurnal

An outbreak of pneumonia occurred among 1,491 recruits undergoing training at the Army Recruit Training Center, Port Dickson, Negeri Sembihxn, between july to August 2000. They had reported for training 2 weeks before and were placed in new modern concrete 4 floors buiMing with well ventilated dorm. A total of 70 recruits were ajjfected and one died. The attack rate was 4.7% and the case fatality rate was 1.4%. The outbreak ajfected recruits from all the jive companies; J (21/299,
30.0%) , G (19/298, 27.1 %), I (14/298, 20.0%), H (13/298, 18.6%) and F (3/298, 4.3%) . The main presenting symptoms were fever (68/70, 97.1%), cough (62/70, 88.6%), and chest pain (35/70, 50 .0%) . This was a common site outbreak with the mode of spread from person to person through infected droplet. The outbreak has three peaks, which was at lst, 4th and 6th week respectively and lasted for eight weeks. The organisms isobted through blood culture were Streptococcal pneumoniae and Klebsiella pneumoniae. All the cases were managed and treated as in-patients at four dijjferent hospitals depending on the severity of the illness. The main control activities carried out were separation of ill recruits from the healthy, reducing the number of recruits in the dormitories and encourage recruits to drink a lot of water while in training.
Fulltext Platelet Rich Plasma Injection for Soft Tissue Musculoskeletal Pain

Irianto KA, Bakri AH, Kloping NA

Malays Orthop J, 2021 Jul;15(2):96-100.
PMID: 34429828 DOI: 10.5704/MOJ.2107.014

Introduction: Treating soft tissue injuries can be a challenge for physicians as it can be overlooked which can lead to more problems. In recent studies, the use of Platelet Rich Plasma (PRP) has been gaining popularity for soft tissue injuries because of its benefits and minimal side effects. This study aims to evaluate the effect of PRP injection on various musculoskeletal soft tissues inflammation.
Material and Methods: This is a retrospective study of patients with soft tissue injury who underwent PRP therapy between 2015 and 2018 at an orthopaedic and traumatology hospital. The study collected demographic data including the type of soft tissue injury and Visual Analog Scale (VAS) before and after the PRP injection. Those data were statistically analysed to identify the significance of PRP.
Results: Seventy-six patients were included, predominantly female, middle aged (40-69 years old) and class one obesity. Most of the complaints (61.8%) were in the lower extremity region. Pain improvements measured with mean VAS score were observed in both acute (3.06±1.28 to 0.8±0.65) and chronic (4±1.75 to 0.97±0.62) cases. There was a significant decrease of VAS score before and after the PRP injection (p < 0.000).
Conclusion: PRP injection is able to alleviate both acute and chronic pain in soft tissue injuries without additional analgesic.
Spontaneous Thyroid Haemorrhage: A Cause of Upper Airway Obstruction

Wong M, Kanapaty Y, Liew YT, Bakri A

Acute Med, 2019;18(4):248-250.
PMID: 31912057

BACKGROUND: Spontaneous thyroid haemorrhage is a very rare condition that is potentially life-threatening. We report an unusual case of spontaneous thyroid haemorrhage leading to airway compromise requiring urgent intervention. We highlight key clinical findings and management steps with comparison to similar cases in the literature.
CASE SUMMARY: An adult male presented with sudden anterior neck swelling and bruises on his neck and chest with hoarseness and dysphagia. Clinical assessment and CT scan revealed a thyroid haemorrhage with laryngopharyngeal, neck and chest haematoma. He was intubated for airway protection and given intravenous steroids and antibiotics. He was extubated well after 3 days.
CONCLUSION: Careful prompt management of the patient's airway is of vital importance as worsening haematoma can lead to rapid airway compromise. Acute physicians should be aware of the clinical signs of thyroid haemorrhage, as this rare condition may present to the acute medical take.
Fulltext Dancing pharynx

Liew YT, Junior ACG, Bakri A, Narayanan P

Ci Ji Yi Xue Za Zhi, 2020 04 01;32(3):303-304.
PMID: 32955511 DOI: 10.4103/tcmj.tcmj_245_19
'Pai Syndrome' with anterior alveolar polyp: A variant of a rare clinical entity

Debnath KK, Kanapaty Y, Yong DJ, Chandran S, Bakri A

Med J Malaysia, 2019 Jun;74(3):229-230.
PMID: 31256179

'Pai syndrome' (PS) is a rare congenital syndrome. Presented here, a new-born baby-girl who exhibited the characteristic features of having a midline nasal (septal) polyp, an anterior alveolar process polyp, and a pericallosal lipoma associated with corpus callosum dysgenesis of the brain. Both polyps were lined with stratified-squamous epithelium. The overall features were largely consistent with those described by Pai et al., in 1987. A midline cleft-lip (with or without cleft-alveolus) is one of the most common features of the syndrome which was however absent in this case. Instead, an anterior alveolar polyp is present, which is relatively rare.
Fulltext Paediatric oropharyngeal tularaemia requiring surgical intervention

Nemmour A, Bakri A, Fischer CA, Brand Y

BMJ Case Rep, 2019 Sep 06;12(9).
PMID: 31494583 DOI: 10.1136/bcr-2019-229754

Tularaemia is a rare infectious disease endemic in most European countries caused by the bacterium Francisella tularensis 1 Patients often show acute non-specific symptoms, which causes a delay in diagnosis and proper treatment, potentially resulting in significant morbidities such as deep neck abscess, meningitis, endocarditis and septic shock. The authors present a case of a 5-year old boy with a 4-day history of fever, sore throat and painful cervical lymphadenopathy, whose clinical progression worsened despite being treated with recommended antibiotics as per WHO guidelines once the diagnosis of Tularaemia was confirmed by serologic tests. He developed a parapharyngeal abscess and a persistent left necrotic cervical lymph node, which both were surgically drained and excised, respectively, and an extended course of antibiotic was given. Subsequently, the patient fully recovered from the illness and the follow-up was negative for relapse.
Fulltext A cross-section study of the knowledge, risk behaviours and attitude toward HIV/AIDS among factory workers in three states. [Kajian hirisan lintang mengenai pengetahuan, tingkah laku berisiko dan sikap terhadap HIV/AIDS di kalangan pekerja kilang di tiga buah negeri]

Anita S, Khalijah MY, Mahanim MY, Abd Rashid K, Rahimah MA, Ahmad Razin AM, et al.

Malaysian Journal of Public Health Medicine, 2004;4(1):40-46.
MyJurnal

HIV/AIDS is a global issue and the fourth biggest killer worldwide. Report from Ministry Of Health Malaysia showed factory workers are among the social group that are mostly infected (10.4%). A cross~sectional study was carried out to determine the socio-demographic factor and its relationship with knowledge, attitude and HIV-related risk behavior among factory workers in Selangor, Negeri Sembilan and MaIacca. This study involved 3300 factory workers selected randomly and were given self-guided questionnaire. With response rate about 95.4% (3148), the level of knowledge was high (97.3%) and the attitude was positive (81 %). However there was still an amount of fear towards HIV/AlDS patient. Logistic regression showed significant difference (p<0.05) between level of knowledge and ethnic group, income and level of education and between attitude and income and level of knowledge. About 27.7% of respondents smoked cigarette. 4.2% involved with drugs of which 0.7% administered intravenously, 2.3% were homosexuals, 2.5% were bisexuals and 3.1% were hererosexuals. HIV/AIDS prevention and control intervention should take into consideration the local socio-cultural factors and commitment from the top level management in the factory·
Global 30-day morbidity and mortality of surgery for perforated peptic ulcer: GRACE study

Abouelazayem M, Jain R, Wilson MSJ, Martinino A, Balasubaramaniam V, Biffl W, et al.

Surg Endosc, 2024 Aug;38(8):4402-4414.
PMID: 38886232 DOI: 10.1007/s00464-024-10881-0

BACKGROUND: There is little international data on morbidity and mortality of surgery for perforated peptic ulcer (PPU). This study aimed to understand the global 30-day morbidity and mortality of patients undergoing surgery for PPU and to identify variables associated with these.
METHOD: We performed an international study of adults (≥ 18 years) who underwent surgery for PPU from 1st January 2022 to 30th June 2022. Patients who were treated conservatively or had an underlying gastric cancer were excluded. Patients were divided into subgroups according to age (≤ 50 and > 50 years) and time from onset of symptoms to hospital presentation (≤ 24 and > 24 h). Univariate and Multivariate analyses were carried out to identify factors associated with higher 30-day morbidity and mortality.
RESULTS: 1874 patients from 159 centres across 52 countries were included. 78.3% (n = 1467) of the patients were males and the median (IQR) age was 49 years (25). Thirty-day morbidity and mortality were 48.5% (n = 910) and 9.3% (n = 174) respectively. Median (IQR) hospital stay was 7 (5) days. Open surgery was performed in 80% (n = 1505) of the cohort. Age > 50 years [(OR = 1.7, 95% CI 1.4-2), (OR = 4.7, 95% CI 3.1-7.6)], female gender [(OR = 1.8, 95% CI 1.4-2.3), (OR = 1.9, 95% CI 1.3-2.9)], shock on admission [(OR = 2.1, 95% CI 1.7-2.7), (OR = 4.8, 95% CI 3.2-7.1)], and acute kidney injury [(OR = 2.5, 95% CI 1.9-3.2), (OR = 3.9), 95% CI 2.7-5.6)] were associated with both 30-day morbidity and mortality. Delayed presentation was associated with 30-day morbidity [OR = 1.3, 95% CI 1.1-1.6], but not mortality.
CONCLUSIONS: This study showed that surgery for PPU was associated with high 30-day morbidity and mortality rate. Age, female gender, and signs of shock at presentation were associated with both 30-day morbidity and mortality.