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Medical Journal of Malaysia

Z D Zakuan, K Suresh
Polymyxin B and colistin (polymyxin E) were introduced in clinical practice to treat Gram-negative infections in 1950s but their parenteral use waned in 1970s due to toxicity concerns. Resurgence of polymyxins use in Malaysia began approximately in 2009 due to a lack of treatment options for MDR Gram negative superbugs such as Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa. However, limited experience and a lack of widespread availability of up-to-date dosing guidelines could potentially result in incorrect use of these last resort antibiotics by managing doctors...
October 2018: Medical Journal of Malaysia
W W Mak, R A Raja Nurazni, L B Mohamed Badrulnizam
Thyroid disease is common and can have various systemic manifestations including cardiac diseases. Hypothyroidism is commonly associated with sinus bradycardia, low QRS complexes, prolonged QT interval and conduction blocks but rarely may cause arrhythmias. We present a patient who presented with presyncope and supraventricular tachycardia with severe hypothyroidism. Patient responded well to thyroxine replacement with biochemical improvement, the disappearance of arrhythmia after restoration of euthyroidism suggests that hypothyroidism might be the cause of supraventricular tachycardia...
October 2018: Medical Journal of Malaysia
I P Tang, B H Kevin Ng, N Prepageran, S L Donald Ngian, H W Albert Sii
Auditory brainstem implantation (ABI) is the only solution to restore hearing when cochlear nerves are disrupted together with the pathologies where bilateral cochleae do not provide a suitable location for cochlear implantation. We reported first two successful auditory brainstem implantation cases in patients with neurofibromatosis Type II (NF2) with bilateral acoustic neuroma causing bilateral profound sensorineural hearing loss in Malaysia. A good candidate selection, dedicated surgeons and rehabilitation team as well as strong family support are the crucial factors in achieving the best possible surgical, audiological and speech outcomes...
October 2018: Medical Journal of Malaysia
S O Andy Tang, T S Leong, T Ruixin, H H Chua, L P Chew
Systemic Arcanobacterium pyogenes is a rare bacterial infection in humans.1The diagnosis of thrombotic thrombocytopenic purpura (TTP)-like syndrome and infective endocarditis (IE) is often elusive. We report a case of TTP-like syndrome associated with A. pyogenes endocarditis in a post-allogenic transplant patient.
October 2018: Medical Journal of Malaysia
M Razzi, A Nordin
Distal femoral physeal fractures in adolescents are often due to high velocity injuries. We present an unusual case of a non-contact distal femoral physeal fracture that occurred during a football match. A torsional force had been directed at the fracture site occurring at the growth plate causing a transverse fracture rather than a spiral fracture. It is important to be aware that such fractures can occur despite little or no evidence of contact. These type of injuries should also be treated as an emergency to reduce the risk of further complications...
October 2018: Medical Journal of Malaysia
T Loganathan, P Y Mohamed
In November 2016, a 28-year-old Malay man presented to the emergency department in respiratory distress, with a history of fever and sore throat. A clinical diagnosis of acute diphtheria was made and the patient was isolated and ventilated in the intensive care unit, and received diphtheria antitoxin and intravenous antibiotics. Initial laboratory findings failed to confirm diphtheria, leading to discontinuation of antibiotics and quarantine. Public health measures were reinstated after a reference laboratory cultured Corynebacterium diphtheriae...
October 2018: Medical Journal of Malaysia
S W Lee, C H Loo, W C Tan
Confluent and reticulated papillomatosis (CRP) was first described in 1927 by Gougerot and further characterised by Carteud.1 It is relatively rare, and the exact pathophysiology was not well known. Over the years, multiple treatment modalities were proposed. We report our experience with three cases of CRP which showed complete clearance with tetracycline group of antibiotics.
October 2018: Medical Journal of Malaysia
R L Ng, A Z Azriyanti
We report a case of benign transient hyperphosphatasaemia (BTH) which was noted incidentally when the patient was admitted for acute tonsillitis. Blood result showed alkaline phosphatase (ALP) at admission was markedly elevated with value of 2481 U/L [normal range 34 - 104 U/L]. He had no history or physical findings to suggest liver or bone disease. Various blood and radiographic investigations were performed to determine the cause but results were normal. He was followed-up with repeat blood test and the alkaline phosphatase normalised after 42 days...
October 2018: Medical Journal of Malaysia
L P Tan, K K Foong, L L Yvonne Ai
Amebiasis is one of the major causes of diarrhea in the developing countries and it can present with a wide range of gastrointestinal symptoms depending on the phase of infection. We described a case of 50 year-old male patient who presented with abdominal pain, diarrhea and vomiting. After right hemicolectomy for appendicular abscess with tumour over the ileum, histopathological examinations revealed numerous trophozoites of Entamoeba histolytica in a background of inflammations (Figure 1). Following resection of the ameboma, he received intravenous metronidazole treatment for total of two weeks duration...
October 2018: Medical Journal of Malaysia
Y Y Sum, W W Sim, K L Yu, T Melee, P J Voon
No abstract provided.
October 2018: Medical Journal of Malaysia
C L Sidney Ong, L S Ch'ng, A A Aida Bt
Coarctation of the aorta (CoA) is present in 0.4% of live births and in 7% of patients with congenital heart disease. While there may be florid presentations of congestive heart failure in the neonatal period, the diagnosis during adulthood is often delayed. We encountered a 20-year-old woman who was discovered to be hypertensive on routine check-up. Following bilateral abnormal renal doppler sonography, MR angiogram revealed a short-segment stenosis of the descending thoracic aorta. Review of her chest radiograph showed a small aortic knuckle...
October 2018: Medical Journal of Malaysia
R L Ng
A 5-year-old girl presented with three brief episodes of afebrile seizure within 24 hours. There was no significant past medical history but she had symptoms of acute gastroenteritis for the past 2 days. She was mildly dehydrated with no neurological signs. Serum electrolytes and blood sugar were normal and cerebrospinal fluid examination was negative for meningoencephalitis. Contrast-enhanced CT Brain showed no evidence of intracranial lesion, haemorrhage or meningeal enhancement. Only stool investigation was positive for Rotavirus...
October 2018: Medical Journal of Malaysia
X Gregory, N I Soon, R Nur Aklina
Kimura's disease is a rare chronic inflammatory disease of unknown etiology, commonly presenting with painless lymphadenopathy and subcutaneous masses in the head and neck regions.1 However, presentations with inguinal lymphadenopathy are rare and mimics other differentials, may pose a diagnostic challenge. We present a case of a 50-year-old male, with right inguinal swelling for one month duration that was finally diagnosed with Kimura's Disease after a multitude of investigations to rule out differentials of lymphadenopathy, delaying conclusive treatment...
October 2018: Medical Journal of Malaysia
Z A Nor Hidayah, O Azerin, A Mohd Nazri
Acute Rheumatic fever (ARF) is commonly associated with ECG abnormalities particularly atrioventricular block. However, third degree atrioventricular block or complete heart block is a rare manifestation. Most cases occurred in children. We reported a 25 year old man who developed complete heart block during an acute episode of ARF. He presented to hospital with five days history of fever, malaise and migrating arthralgia, followed by pleuritic chest pain. One day after admission his electrocardiogram (ECG) revealed complete heart block...
October 2018: Medical Journal of Malaysia
L Jesslyn, K C Ngah, R Muhammad Zaidulkhair Mhd, S Ashwini
Van Bogaert Scherer Epstein Disease is a rare autosomal recessive condition involving abnormal deposition of cholesterol and cholestanol in various parts of body, various clinical symptoms manifest on different age group, significantly neurological impairment in late presentation. We are reporting a slow learner young lady presented with bilateral painless ankle swelling, our initial clinical impression were torn Achilles tendon or Haglund's deformity. On further detail history taking, it leads us towards this disease and confirmed with biopsy...
October 2018: Medical Journal of Malaysia
M Y Nurul Anis, C D Normah, A Mahadir, I Norhayati, A R Rogayah, H Dzalani
INTRODUCTION: Dyslexia is a neurobiological impairment that primarily affects reading ability. It is commonly known as a reading disorder which is likely to be present at birth and is generally identified at pre-school level. Dyslexia is manifested through difficulties with accurate word recognition and also by poor performance in reading and writing. METHOD: The main objective of this paper is to review the various methods or treatments that are used to manage the literacy and cognitive abilities for children with dyslexia particularly in Malaysia...
October 2018: Medical Journal of Malaysia
W T Wan Rohani, A Mahfudzah, M Y Nazihah, H L Tan, W G Wan Syamimee, P-G Amanda Jane, M Tony Richard
INTRODUCTION: Gout is one of the most common inflammatory arthritis in Malaysia. It is due to persistent hyperuricemia that leads to the formation and deposition of intra- and periarticular monosodium urate crystals either due to excessive production or insufficient excretion of uric acid. Incidence and prevalence of gout is increasing worldwide, with a higher rate among men compared to women. Malay is the largest ethnic group in Malaysia, followed by Chinese and Indian. SLC2A9 is a renal urate transporter that controls renal uric acid excretion and genetic variants in SLC2A9 are associated with the risk of gout in several populations...
October 2018: Medical Journal of Malaysia
M H Syahnaz, J K Rasina Nilofer, M W Azmawati, S Harlina Halizah
BACKGROUND: The practice of modern contraceptives still remains a sceptical issue in the society and dormant due to increasing objection of husbands who play a significant role in the family planning practice. OBJECTIVES: This study was done to determine the factors affecting the ever use of modern contraceptive methods among married men visiting a healthcare clinic in Malaysia. MATERIAL AND METHOD: A cross sectional study of 443 men aged over 18 years was conducted using convenient sampling from January 2016 till March 2016 at a primary care clinic...
October 2018: Medical Journal of Malaysia
K W Liew, S Siti Zubaidah, L Doreen
BACKGROUND: Malignant phyllodes tumors of the breast are uncommon fibroepithelial breast tumors with diverse biological behavior. Our study aim is to share our experience in treating patients with malignant phyllodes presenting to our center. PATIENTS AND METHODS: A total of 11 cases of malignant phyllodes were retrospectively reviewed between Nov 2014 and Oct 2017. RESULTS: The median age was 45 years old (31- 61 years). The median pathological tumor size was 10...
October 2018: Medical Journal of Malaysia
H Nirwati, M S Hakim, S Darma, M Mustafa, T Nuryastuti
INTRODUCTION: Acinetobacter baumannii (A. baumannii) is commonly found as an agent of nosocomial infections and demonstrates a high antibiotic resistance due to its carbapenemase production. The objectives of this study were to explore the antibiotic resistance pattern, the presence of OXAs genes and the biofilm-producing capacity of A. baumannii isolated from clinical specimens. METHODS: Antibiotics susceptibility testing, detection of OXAs genes and the biofilm-producing capacity were performed using the Kirby Bauer method, polymerase chain reaction (PCR) and adherence quantitative assays, respectively...
October 2018: Medical Journal of Malaysia
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