1.An Observational Study of Blood Glucose Levels during Admission and 24 Hours Post-Operation in a Sample of Patients with Traumatic Injury in a Hospital in Kuala Lumpur
Rahmat Harun @ Haron ; Musa Kamarul Imran ; Mohammed Saffari Mohammed Haspani
Malaysian Journal of Medical Sciences 2011;18(4):69-77
Background: Traumatic brain injury (TBI) has been associated with an acute stress response mediated by the sympathoadrenomedullary axis, which can be assessed by measuring blood glucose level.
Methods: This prospective observational study was conducted for a year in 2007 among 294 patients who had been treated for TBI in Hospital Kuala Lumpur. Patients fulfilling the set criteria were recruited into the study and data, including blood glucose level and Glasgow Outcome Score at 3-month follow-up, were collected.
Results: 294 patients were included in the study: 50 females (17.0%) and 244 males (83.0%). The majority of cases were young adult patients (mean age of 34.2 years, SD 13.0). The mean blood glucose level during admission and post-surgery were 6.26 mmol/L (SD 1.30, n = 294) and 6.66 mmol/L (SD 1.44, n = 261), respectively. Specifically, the mean admission glucose level associated with mild TBI was 5.04 mmol/L (SD 0.71); moderate TBI, 5.78 mmol/L (SD 1.02); and severe TBI, 7.04 mmol/L (SD 1.18). The mean admission glucose level associated with a poor outcome in patients with isolated TBI was 6.98 mmol/L (SD 1.21). Patients with admission glucose of 5.56 mmol/L (SD 1.21) were more likely to have a favourable outcome.
Conclusion: Mild, moderate, and severe TBI were associated with an increase in blood glucose levels during admission, and the mean increase in glucose levels is based on the severity of the isolated TBI. Surgical intervention did not cause further significant changes in blood glucose levels. Patients with isolated TBI and minimal increases in blood glucose levels were more likely to have a favourable outcome.
2.Brain Metastasis of Atrial Myxoma: Case report
Badrisyah Idris ; Saiful Razman ; Rahmat Harun ; Venkatesh R Naik ; Tan Y C
The Medical Journal of Malaysia 2012;67(6):613-615
Metastasis of an atrial myxoma to the brain is extremely
rare1. Thus far there are only 17 cases reported, including
our present case. Most of the brain metastases manifest
only in 3 to 6 decades, after an average time frame of one to two years after surgical removal of parental tumour. We
present a case of brain metastases of atrial myxoma in a
teenager of the youngest age among all reported cases,
unusually as early as 15 years old 3. The progress of the
metastatic process had been insidious for three years after
heart surgery, The imaging demonstrated a rather sizeable
tumour by the time when the patient is symptomatic. The
location of the metastatic tumour is anyhow superficial to
the cortical surface, enabling complete surgical excision of the tumour easily achievable with favourable outcome.