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Preview: pubmed: Med J Malaysia[Jour]

pubmed: Med J Malaysia[Jour]



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Dengue shock syndrome with retroperitoneal haematoma requiring repeated artery angioembolization.

Dengue shock syndrome with retroperitoneal haematoma requiring repeated artery angioembolization.

Med J Malaysia. 2017 Aug;72(4):254-256

Authors: Teh YH, Tan YP, Zain MM

Abstract
Eyelid reconstruction is complex and challenging since it is not only for structural and functional restoration, but also for an acceptable aesthetic result. In full thickness eyelid injuries, it will involve both anterior and posterior lamella. Therefore, when reconstructing the defect, it requires at least two layers; one will be a flap with blood supply, and the other can be a free graft. In this case, a rotational advancement cheek flap and composite graft were used to reconstruct the lower eyelid.

PMID: 28889142 [PubMed - in process]




Case report: A case of pericardial effusion presenting to primary care.

Case report: A case of pericardial effusion presenting to primary care.

Med J Malaysia. 2017 Aug;72(4):252-253

Authors: Devaraj NK

Abstract
This is a rare but interesting case of Mr. MZ who had a lifethreatening pericardial effusion presenting to the primary care clinic. Through great clinical acumen and prudent targeted investigations, diagnosis of this rare condition was reached and urgent referral made to the cardiology team which performed an emergency pericardiocentesis which proved to be life -saving. However, the hovering poor prognosis of Mr. MZ may prompt for a referral to the palliative care team to provide quality end of life care for this unfortunate patient.

PMID: 28889141 [PubMed - in process]




Multiple bilateral renal abscesses in a previously healthy young patient.

Multiple bilateral renal abscesses in a previously healthy young patient.

Med J Malaysia. 2017 Aug;72(4):250-251

Authors: Tang RY, Cheong BM

Abstract
The incidence of renal abscesses is not common. Patients usually have risk factors like diabetes mellitus or an underlying condition which predisposes to urinary tract infections. We report a case of a previously healthy young girl with multiple bilateral renal abscesses. Ultrasonography revealed multiple renal abscesses with a possible differential diagnosis of polycystic kidney disease with infected cysts. No renal calculi were seen. CT-scan of kidneys confirmed the diagnosis. Blood and urine cultures were repeatedly negative. She was treated with two weeks of intravenous antibiotics followed by another four weeks of oral Ciprofloxacin. No surgical intervention was carried out. Repeated ultrasound at six months showed complete resolution of all the renal abscesses.

PMID: 28889140 [PubMed - in process]




Bohring-opitz syndrome - A case of a rare genetic disorder.

Bohring-opitz syndrome - A case of a rare genetic disorder.

Med J Malaysia. 2017 Aug;72(4):248-249

Authors: Visayaragawan N, Selvarajah N, Apparau H, Kamaru Ambu V

Abstract
The diagnostic challenge of Bohring-Opitz Syndrome, a rare genetic disorder has haunted clinicians for ages. Our patient was born at term via caesarean-section with a birth weight of 1.95 kilograms. She had mild laryngomalacia, gastroesophageal reflux disease and seizures. Physical signs included microcephaly, hemangioma, low set ears, cleft palate, micrognatia and the typical BOS posture. Chromosomal analysis showed 46 xx -Bohring-Opitz Syndrome overlapped with C- syndrome. Goal-directed holistic care with integration of parent/carer training was started very early. She succumbed to a Respiratory- Syncitial-Virus and Pseudomonas pneumonia complicated with sepsis at the age of two years and 11 months.

PMID: 28889139 [PubMed - in process]




Pulmonary actinomycosis masquerading as lung cancer: A case report.

Pulmonary actinomycosis masquerading as lung cancer: A case report.

Med J Malaysia. 2017 Aug;72(4):246-247

Authors: Boo YL, How KN, Pereira DS, Chin PW, Foong KK, Lim SY

Abstract
Pulmonary actinomycosis is a rare yet important and challenging diagnosis to make. It is commonly confused with other lung diseases, such as tuberculosis and bronchogenic carcinoma, leading to delay diagnosis or misdiagnosis. A 49-year-old man presented with a chronic cough, hemoptysis, and pleuritic chest pain. His initial imaging studies including computed tomography (CT) was suggestive of bronchogenic carcinoma. A subsequent CTguided biopsy was consistent with pulmonary actinomycosis and excluded the possibility of bronchogenic carcinoma. He was treated with antibiotic therapy and achieved remission with complete radiological resolution upon follow-up.

PMID: 28889138 [PubMed - in process]




Perforated gastric ulcer in severe dengue infection: A case report.

Perforated gastric ulcer in severe dengue infection: A case report.

Med J Malaysia. 2017 Aug;72(4):244-245

Authors: Ng CY, Lee SL, Foo SL

Abstract
Abdominal pain is one of the common presentations in severe dengue infection. We report a rare case of perforated gastric ulcer in a young man diagnosed with severe dengue infection and the challenges we faced in managing this patient. Perforated gastric ulcer need to be considered if there are signs of peritonitis and persistent abdominal pain that does not conform to the natural history of dengue. Proper imaging and early surgical intervention in perforated gastric ulcer is vital in preventing further complication and reducing the risk of mortality.

PMID: 28889137 [PubMed - in process]




Electro-navigational bronchoscopy for bilateral peripheral lung lesions: A case report.

Electro-navigational bronchoscopy for bilateral peripheral lung lesions: A case report.

Med J Malaysia. 2017 Aug;72(4):241-243

Authors: Faisal AH, Sopian AW, Tidi H

Abstract
Electromagnetic navigational bronchoscopy (ENB), one of the methods of navigational bronchoscopy is an advanced diagnostic tool allowing tissue sampling at the lung peripheries which were previously accessible only by computed tomography (CT) guidance or video-assisted thoracoscopic surgery (VATS). We report a 53-year-old man who presented with a cough and dyspnea with constitutional symptoms for one month. CT thorax revealed multiple bilateral peripheral lung nodules and there were no endobronchial lesions on flexible bronchoscopy. ENB was performed using a loan machine from Veran navigational technology. Biopsy successfully revealed small cell carcinoma of the lung thus preventing him from undergoing a more invasive diagnostic procedure. This case highlights the utility of ENB in the evaluation of peripheral lung nodules that were inaccessible by conventional bronchoscopy. This is one of the first few successful applications of Veran ENB in Asia.

PMID: 28889136 [PubMed - in process]




Acute outcome of chronic total occlusion (CTO) recanalizsation in the elderly.

Acute outcome of chronic total occlusion (CTO) recanalizsation in the elderly.

Med J Malaysia. 2017 Aug;72(4):236-240

Authors: Guelker JE, Rock T, Ott R, Katoh M, Kroeger K, Guelker R, Klues HG, Shin DI, Bufe A

Abstract
OBJECTIVES: Percutaneous coronary intervention (PCI) of total chronic total occlusion (CTO) still remains a major challenge in interventional cardiology. There is only insignificant knowledge reported in the literature about age differences in CTO recanalization. We analyzed in this study the issue of the impact of age on procedural characteristics, complications and short-term outcome.
METHODS: Between 2012-2016 we included 440 patients. They underwent PCI for at least one CTO. Antegrade and retrograde CTO techniques were applied. The retrograde approach was used only after failed antegrade intervention. Continuous data are presented as the mean ± standard deviation; categorical data are presented as numbers and percentages unless otherwise specified. We used Twosamplet- t-test with equal variance to test the significant differences of the variables between the two cohorts.
RESULTS: Procedural success proved independently of age. There was no significant interaction between age and procedural success (p=0.5). Complication rates were low in both groups (2.7% vs. 4%; p=0,4) with no difference in statistical significance.
CONCLUSIONS: Our study suggests that in an aging society patients with severe coronary artery disease and chronical total occlusions an interventional therapy should be used more intensively. It can be performed safe and feasible.

PMID: 28889135 [PubMed - in process]




Pesticide applicators questionnaire content validation: A fuzzy delphi method.

Pesticide applicators questionnaire content validation: A fuzzy delphi method.

Med J Malaysia. 2017 Aug;72(4):228-235

Authors: Manakandan SK, Rosnah I, Mohd Ridhuan J, Priya R

Abstract
BACKGROUND: The most crucial step in forming a set of survey questionnaire is deciding the appropriate items in a construct. Retaining irrelevant items and removing important items will certainly mislead the direction of a particular study. This article demonstrates Fuzzy Delphi method as one of the scientific analysis technique to consolidate consensus agreement within a panel of experts pertaining to each item's appropriateness. This method reduces the ambiguity, diversity, and discrepancy of the opinions among the experts hence enhances the quality of the selected items. The main purpose of this study was to obtain experts' consensus on the suitability of the preselected items on the questionnaire.
METHODS: The panel consists of sixteen experts from the Occupational and Environmental Health Unit of Ministry of Health, Vector-borne Disease Control Unit of Ministry of Health and Occupational and Safety Health Unit of both public and private universities. A set of questionnaires related to noise and chemical exposure were compiled based on the literature search. There was a total of six constructs with 60 items in which three constructs for knowledge, attitude, and practice of noise exposure and three constructs for knowledge, attitude, and practice of chemical exposure. The validation process replicated recent Fuzzy Delphi method that using a concept of Triangular Fuzzy Numbers and Defuzzification process.
RESULTS: A 100% response rate was obtained from all the sixteen experts with an average Likert scoring of four to five. Post FDM analysis, the first prerequisite was fulfilled with a threshold value (d) ≤ 0.2, hence all the six constructs were accepted. For the second prerequisite, three items (21%) from noise-attitude construct and four items (40%) from chemical-practice construct had expert consensus lesser than 75%, which giving rise to about 12% from the total items in the questionnaire. The third prerequisite was used to rank the items within the constructs by calculating the average fuzzy numbers. The seven items which did not fulfill the second prerequisite similarly had lower ranks during the analysis, therefore those items were discarded from the final draft.
CONCLUSION: Post FDM analysis, the experts' consensus on the suitability of the pre-selected items on the questionnaire set were obtained, hence it is now ready for further construct validation process.

PMID: 28889134 [PubMed - in process]




Prevalence and predictors of depression and suicidal ideation among adolescents attending government secondary schools in Malaysia.

Prevalence and predictors of depression and suicidal ideation among adolescents attending government secondary schools in Malaysia.

Med J Malaysia. 2017 Aug;72(4):221-227

Authors: Ibrahim N, Sherina MS, Phang CK, Mukhtar F, Awang H, Ang JK, Zubaidah JO, Ab Ghaffar SF

Abstract
No abstract available.

PMID: 28889133 [PubMed - in process]




Food allergy and allergic rhinitis in 435 asian patients - A descriptive review.

Food allergy and allergic rhinitis in 435 asian patients - A descriptive review.

Med J Malaysia. 2017 Aug;72(4):215-220

Authors: Pang KA, Pang KP, Pang EB, Tan YN, Chan YH, Siow JK

Abstract
OBJECTIVE: To describe the prevalence of food allergy in Asian patients with allergic rhinitis.
STUDY DESIGN: A non-randomized prospectively collected patients over a three year period, with complaints of nose congestion, rhinorrhea and/or nasal discharge.
RESULTS: There were 435 patients enrolled, 213 children and 222 adults. The children group had a high prevalence of allergen specific IgE to Dermatophagoides pteryonysinus (70%), Dermatophagoides farina (69%), and Blomia tropicalis (55%); followed by dogs (32%), cats (19%) and cockroaches (19%). In the children food allergy category, the top three allergens were egg white (54%), milk (31%) and soya bean (13%). The adult group had results of Dermatophagoides pteryonysinus (71%), Dermatophagoides farina (72%), and Blomia tropicalis (59%); the adult food allergy category, the top 3 allergens were egg white (13%), milk (6%) and soya bean (5%). There was a statistically significant difference in the child and adult group for Dust, D. pteryonysinus, D. farina, B.tropicalis, egg white, wheat, gluten and soya bean. In the age specific child groups, there was an increased in egg food allergy levels, with a peak at the age of five-nine years old and decreasing thereafter (p=0.04). In the children group, the mean Total Nasal Symptom Score (TNSS) was 10.3 (range of 7 to 13); the adult group was similar, with a mean TNSS of 9.8 (range 5 to 12).
CONCLUSION: The prevalence of food allergy in paediatric patients with allergic rhinitis is fairly high and should be considered when treating these children.

PMID: 28889132 [PubMed - in process]




Missed opportunities for earlier HIV-testing in patients with HIV infection referred to a tertiary hospital, a cross-sectional study.

Missed opportunities for earlier HIV-testing in patients with HIV infection referred to a tertiary hospital, a cross-sectional study.

Med J Malaysia. 2017 Aug;72(4):209-214

Authors: Koh KC, Islam M, Chan WK, Lee WY, Ho YW, Alsagoff SAH, Yusof RA

Abstract
INTRODUCTION: In Malaysia, the prevalence of missed opportunities for HIV-testing is unknown. Missed opportunities have been linked to late diagnosis of HIV and poorer outcome for patients. We describe missed opportunities for earlier HIV-testing in newly-HIV-diagnosed patients.
METHODS: Cross sectional study. Adult patients diagnosed with HIV infection and had at least one medical encounter in a primary healthcare setting during three years prior to diagnosis were included. We collected data on sociodemographic characteristics, patient characteristics at diagnosis, HIV-related conditions and whether they were subjected to risk assessment and offered HIV testing during the three years prior to HIV diagnosis.
RESULTS: 65 newly HIV-diagnosed patients (male: 92.3%; Malays: 52.4%; single: 66.7%; heterosexual: 41%; homosexual 24.6%; CD4 <350 at diagnosis: 63%). 93.8% were unaware of their HIV status at diagnosis. Up to 56.9% had presented with HIV-related conditions at a primary healthcare facility during the three years prior to diagnosis. Slightly more than half were had risk assessment done and only 33.8% were offered HIV-testing.
CONCLUSIONS: Missed opportunities for HIV-testing was unacceptably high with insufficient risk assessment and offering of HIV-testing. Risk assessment must be promoted and primary care physicians must be trained to recognize HIV-related conditions that will prompt them to offer HIVtesting.

PMID: 28889131 [PubMed - in process]




Experience of a rapid access falls and syncope service at a teaching hospital in Kuala Lumpur.

Experience of a rapid access falls and syncope service at a teaching hospital in Kuala Lumpur.

Med J Malaysia. 2017 Aug;72(4):203-208

Authors: Gan SY, Saedon NI, Sukanya S, Fairuz NHA, Sakinah SMN, Fatin NIAH, Imran ZA, Chee KH, Teo JYL, Tan MP

Abstract
No abstract available.

PMID: 28889130 [PubMed - in process]




Abstracts of 5th Asia Pacific Conference on Public Health Supplement.

Abstracts of 5th Asia Pacific Conference on Public Health Supplement.

Med J Malaysia. 2017 Aug;72(Suppl 1):1-92

Authors:

PMID: 28889129 [PubMed - in process]