1.Diphtheria Anti-toxoid Antibody Levels Among Pre-clinical Students and Staff in an Institute of Higher Learning in Malaysia: Are They Protected?
RA Hamat ; O Malina ; YJ Chua ; KL Seng ; M Zubaidah ; K Norhanim ; SS Chong ; PL Weng ; J Farida
Malaysian Journal of Medicine and Health Sciences 2011;7(1):27-34
Introduction: Little is known about the sero-prevalence of diphtheria anti-toxoid antibody levels
among medical students in Malaysia. They too, just like other health care workers (HCWs) are at
risk of contracting and transmitting diphtheria. Fortunately, this can be prevented by giving a specific
vaccine: the diphtheria, tetanus and pertussis (DTP) vaccine. Nonetheless, data from local or regional
surveys are needed before any decision is made by the respective authorities. General objective: We
studied the epidemiology of diphtheria anti-toxoid antibody levels and vaccination history amongst
medical students and staff in Faculty of Medicine and Health Sciences, Universiti Putra Malaysia.
Specific objectives: We determined the level of diphtheria anti-toxoid antibodies amongst pre-clinical
students and staff. Methodology: A total of 152 sera were collected from subjects aged 19 to 63, and
diphtheria anti-toxoid levels were measured by an enzyme-linked immunosorbent assay. Results: One
hundred and fifty-two (94.4%) blood samples out of 161 participants were successfully withdrawn,
which comprised 105 (69.1%) and 47 (30.9%) medical students and staff, respectively. A total of 77.6%
and the other 22.4% of the subjects had full and basic protection, respectively. Higher levels were
predominant amongst males and they were 1.3 times more protected than females in 20-29 year-old
group (85.1% vs 66.2%; odd ratios 1.25 [95% CI 1.03-1.50]; P=0.03). No significant difference in the
levels of immunity among subjects for ethnicity and academic position (P>0.05). Recommendations:
Level of full protection against diphtheria toxin should be clearly defined by broad population based
studies using several comparable detection methods. Medical students and staff with basic protection
should be closely monitored or should be given a booster dose for those who are at high risk of acquiring
the disease. Thus, a standard degree of coverage should be clearly determined for health workers to
prevent a potential outbreak. Conclusion: Students and staff possess immunity towards diptheria toxin
however the level of full protective antibody is yet to be determined in future.
3.Outcomes in Nonagenarians with Hip Fractures Treated Conservatively and Surgically
Malhotra R ; Huq SS ; Chong M ; Murphy D ; Daruwalla ZJ
Malaysian Orthopaedic Journal 2021;15(No.3):21-28
Introduction: We aimed to assess the clinical outcomes in
nonagenarians following a hip fracture. We also further
investigated the factors that influence these outcomes, such
as method of treatment (operative versus conservative), comorbidities, and pre-morbid function.
Materials and methods: We studied 65 nonagenarians that
were identifiable from our hospital hip fracture database. We
reviewed various parameters of these patients admitted after
sustaining a hip fracture (neck of femur or intertrochanteric)
and investigated how these parameters affected patient
outcomes. The main outcomes studied were: inpatient
morbidity, and mortality at one year.
Results: Inpatient morbidity was more likely in patients with
an ASA grade of 3 to 5. Urinary tract infection was the most
common medical complication. The 1-year mortality was
15.4% and was significantly influenced by advancing age.
Surgically managed patients had a 1-year mortality rate
(14.3%) slightly less than non-operative patients (17.4%).
Post injury mobility was significantly better in those who
received operative treatment with 63% of surgical cases
regaining ambulatory status versus 7% of conservatively
managed patients.
Conclusions: We presented the outcomes of hip fractures in
an extreme age group in the population. In nonagenarians
with hip fractures surgery was associated with a 1-year
mortality rate of 14.3% which is comparable to the general
hip fracture population and less than the mortality rate of
conservatively managed patients (17.4%). The primary
advantage of surgery would be that two-thirds of patients
return to ambulatory status. This information is useful to
counsel patients and their families especially since the
elderly are often more fearful of surgical intervention.
4.A Rare Case Of Pronator Teres Syndrome & Accompanying Anterior Interosseous Nerve Syndrome
Toyat SS ; Chong WJ ; Kandiah S ; Lakshen P ; Zulkifli EM ; Kamil MK ; Chuah CK ; Tiew SK
Malaysian Orthopaedic Journal 2018;12(Supplement A):85-