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  1. A case of cough induced rib fracture with subcutaneous emphysema and pneumothorax
    Shukri WNA, Ng VH, Ismail AK
    Med J Malaysia, 2019 12;74(6):551-552.
    PMID: 31929488
    Coughing is an important reflex mechanism which enhances the clearance of secretions and particulates from the airways, however repetitive muscle strain due to prolonged coughing may cause the uncommon complication of stress fracture of the ribs. The following is an unusual case of cough induced multiple rib fractures associated with subcutaneous emphysema and pneumothorax which was missed in the emergency setting. Delayed diagnosis and treatment would have been avoided if this uncommon condition was considered as a possibility.
  2. Fulltext Estimation of local incidence of jellyfish envenomation in developed marine coastal areas and large populated island on the western coast of Peninsular Malaysia using case surveillance of government health facilities in Manjung, Perak and Langkawi Island
    Mubarak AI, Wan Mohd Shukri WNA, Ismail AK
    Int Marit Health, 2021 7 3;72(2):93-98.
    PMID: 34212348 DOI: 10.5603/IMH.2021.0017
    BACKGROUND: Jellyfish stings are one of the commonest causes of marine animal related injuries in human. Despite mostly being harmless, box jellyfish species can cause major stings with fatalities or systemic envenoming symptoms. There are 15-20 species identified to be life-threatening. There are few reported cases that suggest the presence of deadly box jellyfish in the Malaysian coast. However, numbers of stings around Malaysia are still under reported.

    MATERIALS AND METHODS: This observational study was conducted in Manjung, Perak and Langkawi Island to look at the pattern and incidence of jellyfish stings which occur within 1 year.

    RESULTS: There were 45 sting incidents reported with the highest number of cases occurred in December and February. Cases mainly involved young adults aged 10 to 29 years old. The most common clinical symptom that presented was sudden and persistent pain. Vinegar was applied as first aid in 53.3% of reported stings. All patients were treated symptomatically and discharged well. Stings occurred at mean sea surface temperature of 29.38°C and the wind speed of 7.6 knots. All cases were mild and did not require antivenom.

    CONCLUSIONS: The study showed that the occurrence of jellyfish stings are affected by weather conditions. Jellyfish stings occur seasonally, thus making it predictable and easily preventable with public awareness, early first aid application and use of jellyfish nets.

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