MyMedR

Immunisation services: maternal and child health clinic of City Hall, Kuala Lumpur

George J

Family Practitioner, 1988;11(1):71-72.

Fulltext Usefulness of conventional ultrasonography in identifying normal and abnormal gastric antrum

George J

Singapore Med J, 1996 Apr;37(2):181-3.

This study evaluates the usefulness of measuring gastric antral thickness on conventional ultrasonography as a means of suggesting gastric antral pathology. Normal and abnormal appearances of the gastric antrum are reviewed.

Fulltext The Role of Real Time Ultrasound in Differentiatingbetween Osteomyelitis and Tumour in Long Bones

George, J., Teo, S.C., Adan, M.

Malays Orthop J, 2008;2(1):33-37.

MyJurnal

Aim: This study was designed to evaluate the use of ultrasound in diagnosis of infection and tumour of long bones. Methodology: Patients referred from the orthopaedic unit with doubt regarding long bone clinical and/or radiological signs which could be tumour or infection were enrolled in this study. Analysis of ultrasound characteristics included presence of pericortical fluid over normal cortex well away from the primary lesion, wavy contour sign (fluid tracking in and out muscle planes), subperiosteal fluid and soft tissue mass displacing adjacent muscle planes. Results: Fourteen out of 15 patients with confirmed osteomyelitis were diagnosed by ultrasound examination. Ultrasound as a diagnostic tool has a sensitivity of 93% and specificity of 100%. The most accurate indicator was pericortical fluid noted up to several centimetres from the long bone abnormality seen on plain x-rays. Conclusion: Ultrasound is a safe, fast, cost-effective imaging modality that can play an important role in diagnosis of osteomyelitis as it then serves as a tool for ultrasound guided aspiration.

Cervical osteoarthropathy: an unusual cause of dysphagia

Srinivas P, George J

Age Ageing, 1999 May;28(3):321-2.

PMID: 10475873

PRESENTATION: A 72-year-old man complained of progressive dysphagia for solids associated with a sensation of foreign body in his throat for 2 years. A barium swallow showed a bridging osteophyte between C4 and C5 vertebrae indenting the oesophagus posteriorly and displacing it anteriorly.

OUTCOME: He refused surgical intervention and was given dietary advice. After 6 months, his weight was steady and he was able to swallow semi-solid food without difficulty.

Fulltext Ultrasound-guided percutaneous trucut needle biopsy for musculoskeletal tumours

Sallehuddin, A., Saw, A., George, J., Sengupta, S.

Malays Orthop J, 2008;2(1):12-16.

MyJurnal

Purpose: To evaluate the usefulness of ultrasound guidance in percutaneous needle biopsy for musculoskeletal tumours.
Methods: Forty-five consecutive patients underwent ultrasound-guided needle biopsy. An additional group of 50 patients who underwent needle biopsy without ultrasound guidance was retrospectively selected as historical control. The sample was considered adequate when a diagnosis can be made, and diagnostic when the diagnosis is similar to the final report based on the excised tumour.
Results: Adequacy of the biopsy samples was 84% in ultrasound-guided group as compared 76% in the group with no ultrasound guidance. Diagnostic accuracy was 64% in the ultrasound-guided group and 52% in the group without ultrasound guidance. Both of these differences were not statistically significant.
Conclusions: Ultrasound guidance did not provide a significant advantage in the biopsy of musculoskeletal tumours. Diagnostic accuracy seems to improve with the use of larger 14 gauge biopsy needle but further evaluation is necessary.

Fulltext Disseminated Penicilium marneffei infection

Beh CP, George J

Med J Malaysia, 2009 Mar;64(1):86-8.

PMID: 19852332 MyJurnal

This is a case report of disseminated Penicillium marneffei infection in a patient with leprosy, responding to antifungal therapy. Radiologically there were nodules in the left lung, right pleural effusion, lymphadenopathy in neck, mediastinum and upper abdomen and abscesses in the liver and right parietal lobe. This case highlights a rare infection in a non-HIV related immunocompromised patient, and its nonspecific radiologic manifestations.

Radiological parameters of bleeding renal angiomyolipoma

Koh KB, George J

Scand. J. Urol. Nephrol., 1996 Aug;30(4):265-8.

PMID: 8908645

Angiomyolipomas are rare tumours of the kidney which have a tendency to bleed. We studied the clinical and radiological features of 11 patients from our institution to identify features which may be predictive of a massive haemorrhage. Tumours more than 6 cm in diameter were found to bleed and the demonstration of pseudoaneurysms on contrast CT scanning was associated with massive haemorrhage. We conclude that large angiomyolipomas should be treated to avoid haemorrhage and the detection of pseudoaneurysms should prompt urgent treatment.

Fulltext Metastatic cervical carcinoma presenting as psoas abscess and osteoblastic and lytic bony metastases

George J, Lai FM

Singapore Med J, 1995 Apr;36(2):224-7.

PMID: 7676275

A 60-year-old Chinese lady presented with a left flank mass and weight loss. Plain films showed a sclerotic L1 vertebral body, osteopenic L2 and L3 vertebral bodies and loss of left psoas outline. However initially unrevealed history of previous carcinoma of the cervix caused confusion as to the aetiology of a sclerotic vertebral body associated with an left flank collection. Psoas abscess with adjacent bony osteomyelitis was initially suspected. The left flank mass turned out to be an infected necrotic large metastatic lymph node compressing the lower pole of the left kidney. The sclerotic and osteopenic vertebral bodies represented an unusual presentation of bony cervical carcinoma metastases.

Metabolic fatty liver syndromes: where do we stand in 2024?

Chan WK, George J

J Gastroenterol Hepatol, 2024 Apr;39(4):613-614.

PMID: 38357837 DOI: 10.1111/jgh.16507

Comparison study of growth plate fusion using MRI versus plain radiographs as used in age determination for exclusion of overaged football players

George J, Nagendran J, Azmi K

Br J Sports Med, 2012 Mar;46(4):273-8.

PMID: 21173009 DOI: 10.1136/bjsm.2010.074948

MRI of distal radius fusion is currently being used in the U17 World Cup to exclude overaged players. Developing countries that cannot afford to perform MRI on their players are using plain radiographs based on the same MRI criteria of fusion.

Fulltext Tubercular synovitis mimicking rheumatoid nodules

Teo SC, George J, Kamarul T

Med J Malaysia, 2008 Jun;63(2):159-61.

PMID: 18942309 MyJurnal

Tubercular tenosynovitis is an uncommon condition and usually affects the upper limb. We report a case of a patient with Systemic Lupus Erythematosus who presented with wrist swelling. The clinical findings were suggestive of rheumatoid nodules, but the radiographic finding of calcification associated with the nodules and marked erosive changes primarily of the radio-carpal joint with sparing of the metacarpal joints led the radiologist to believe that the nodules may not be rheumatoid nodules. The presence of solid and fluid nature of the nodule and hyperechoic small echogenic foci (matted rice bodies within thickened synovium) on ultrasound suggested the presence of chronic synovitis of tuberculous infection rather than rheumatoid nodule as in our case. We recommend the use of ultrasound to determine the nature of nodular swellings seen clinically in patients with arthropathy.

Fulltext Prevalence of soil transmitted helminths in school children in the Federal Territory of Malaysia

George J, Ow Yang CK

Med J Malaysia, 1982 Mar;37(1):35-9.

PMID: 7121344

A study conducted in. all the government schools in Wilayah to find the prevalence rate of worm infection in. urban schools revealed that 50 percent of the 7,682 school children. examined suffered from helminthiasis. More than 50 percent had mixed infections, worm infection was more prevalent among Malays and Indians. Both males and females had an equal prevalence of worm infection. Schools near the squatter areas had high infection rates. This was attributed to poverty, cultural factors, and environmental sanitation in the squatter areas.

Universal child immunization coverage in Kuala Lumpur

Sinniah, D., Rajeswari, B., Koh, S., George, J., Sundari, J., Sosapillai, J.N., et al.

Malaysian Journal of Child Health, 1991;3(1):23-28.

MyJurnal

To verify the actual immunisation coverage in Kuala Lumpur, City Hall Health Department and the Malaysian Paediatric Association (NGO ) carried out a survey. The survey revealed that the immunisation coverage determined at the child's first birthday for BCG was 95%, DPT 3 94%, OPV 3 94%, and measles = 27% (59% at 2 years). These figures correspond closer to City Hall's estimated coverage rather than the rates projected by the Ministry of Health. The main reasons for immunisation failure were, child ill 31.8% (not brought = 20.1%, brought but not given vaccine 11.7%), lack of information 28.6%, lack of motivation 9.1%, mother too busy 9.1%. Measles immunisation coverage at 1 year was low because of wrong information on schedules. Tetanus toxoid immunisation coverage of pregnant women was low. Only 27% of children were protected against neonatal tetanus although 97% of pregnant women received antenatal care and 50% had attended other health facilities as well during pregnancy. Private medical practitioners were responsible for more than 40% of all immunisations but were not submitting returns to the Health Department. Recommendations to improve immunisation coverage include education and motivation of the public and also doctors and health personnel on prevention of missed opportunities, contraindictions to immunisation and correct schedules. (Copied from article).

Fulltext Evaluation of radiation dose and image quality following changes to tube potential (kVp) in conventional paediatric chest radiography

Ramanaidu S, Sta Maria R, Ng Kh, George J, Kumar G

Biomed Imaging Interv J, 2006 Jul;2(3):e35.

PMID: 21614244 MyJurnal DOI: 10.2349/biij.2.3.e35

A study of radiation dose and image quality following changes to the tube potential (kVp) in paediatric chest radiography.

Age determination by magnetic resonance imaging of the wrist in adolescent male football players

Dvorak J, George J, Junge A, Hodler J

Br J Sports Med, 2007 Jan;41(1):45-52.

PMID: 17021001

In football there are established age-related tournaments for males and females to guarantee equal chances within the game for all the different age groups. To prevent participation in the incorrect age group, and owing to the fact that in some Asian and African countries registration at birth is not compulsory, other methods of age determination need to be available. Standard radiographs of the left wrist have been used for assessment of skeletal age for many years. This is, however, not ethical in the sporting environment.

Fulltext Ultrasound assessment of synovial thickness of some of the metacarpophalangeal joints of hand in rheumatoid arthritis patients and the normal population

Hussain Manik Z, George J, Sockalingam S

Scientifica (Cairo), 2016;2016:5609132.

PMID: 27190682 DOI: 10.1155/2016/5609132

Objective. To compare ultrasound synovial thickness of the 2nd, 3rd and 4th metacarpophalangeal joints (MCPJ) in a group of patients with proven rheumatoid arthritis (RA) and a control group of normal individuals. Materials and Methods. This is a cross-sectional study comprising 30 rheumatoid arthritis patients and 30 healthy individuals. Ultrasound scans were performed at the dorsal side of 2nd, 3rd, and 4th MCPJ of both hands in RA patients and the healthy individuals. Synovial thickness was measured according to quantitative method. The synovial thickness of RA patients and healthy individuals was compared and statistical cut-off was identified. Results. Maximum synovial thickness was most often detected at the radial side of the 2nd MCPJ and 3rd MCPJ and ulnar side of the 4th MCPJ of both hands which is significantly higher (p < 0.05) in RA patients compared to healthy individuals. With high specificity (96%) and sensitivity (90%) the optimum cut-off value to distinguish RA patients and healthy individuals' synovial thickness differs for the radial side of the 2nd and 3rd MCPJ and ulnar side of the 4th MCPJ. Conclusion. Patients with early RA appear to exhibit a characteristic pattern of synovitis which shows radial side predominance in the 2nd and 3rd MCPJ and ulnar side in the 4th MCPJ.
Study site: University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Fulltext Spontaneous rupture of renal angiomyolipoma presenting as acute abdomen

Koh KB, Wightman JA, George J

Med J Malaysia, 1996 Mar;51(1):148-50.

PMID: 10967998

Five cases of renal angiomyolipoma which underwent spontaneous rupture are described. These patients presented as an "acute abdomen" for which the diagnosis was not initially apparent. A high index of suspicion is required to make the diagnosis even with modern imaging techniques. The treatment of these tumours is discussed.

The role of 67gallium scintigraphy and high resolution computed tomography as predictors of disease activity in sputum smear-negative pulmonary tuberculosis

Lai FM, Liam CK, Paramsothy M, George J

Int J Tuberc Lung Dis, 1997 Dec;1(6):563-9.

PMID: 9487455

University Hospital, Kuala Lumpur, Malaysia.

Fulltext The role of 99mtechnetium (Tc) diethyl-iminodiacetic acid (EHIDA) hepatobiliary scintigraphy in the diagnosis of a rare cause of obstructive jaundice

Lai FM, Paramsothy M, George J, Yip CH

Singapore Med J, 1996 Jun;37(3):261-3.

PMID: 8942223

This paper illustrates the role of 99m-Technetium(Tc) diethyl-iminodiacetic acid (EHIDA) hepatobiliary scintigraphy in a patient who developed obstructive jaundice as a result of afferent loop syndrome, which is a rare occurrence. The computed tomographic (CT) and ultrasonographic findings are also described.

Fulltext Musculoskeletal injuries among Malaysian badminton players

Shariff AH, George J, Ramlan AA

Singapore Med J, 2009 Nov;50(11):1095-7.

PMID: 19960167

The purpose of this study was to investigate the pattern of musculoskeletal injuries sustained by Malaysian badminton players.

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