1.Metabolic syndrome amongst patients with psoriasis in a tertiary dermatology centre, Malaysia
Lee YY ; Lim SS ; Lee CK ; Tan ATB ; Ananda V ; Rokiah P ; Chan SP
Malaysian Journal of Dermatology 2011;27(-):6-6
Background: Psoriasis has been shown to be associated with a higher risk of metabolic syndrome and cardiovascular disease.
Objective: To investigate the prevalence of metabolic syndrome among patients with psoriasis and study the association between psoriasis and cardiovascular risk factors.
Methods: This was a hospital based case-control study conducted at the Dermatology Clinic, University Malaya Medical Centre (UMMC) from May 2010 to March 2011. A total of 131 adult patients with psoriasis and 129 age-, gender- and race-matched controls were recruited. All subjects answered a standardised cardiovascular risks questionnaire and had anthropometric measurements recorded. Laboratory investigations included fasting glucose / lipid profile, erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), urine microalbumin:creatinine ratio and an electrocardiogram. The diagnosis of metabolic
syndrome was made using the harmonised criteria for metabolic syndrome in South East Asians. Statistical analysis was performed using statistical processing software (SPSS-17).
Results: Metabolic syndrome was significantly higher among patients with psoriasis (64.9% versus 51.9%) (p = 0.034). The presence of metabolic syndrome was associated with low high density lipoprotein (HDL) (p=0.002) and high triglyceride (TG) levels (p = 0.014). The prevalence of diabetes mellitus was also significantly higher among patients with psoriasis (46.6% versus
27.1%) (p = 0.001). Hypertension, ischaemic heart disease, low density lipoprotein (LDL) levels, smoking and obesity were not significantly higher among patients with psoriasis.
Conclusion: Our results demonstrate an association between psoriasis and metabolic syndrome which was primarily due to diabetes mellitus and dyslipidaemia.
2.Staphylococcus Aureus Antibiotic Resistance In Atopic Eczema
Lee CK ; Yusof MY ; Lee YY ; Tan ESS ; Wong SM ; Ch’ng CC ; Koh CK
Malaysian Journal of Dermatology 2016;36(1):5-10
Background: Atopic Dermatitis (AD) is a chronic relapsing, pruritic inflammation of the skin which is often colonized by Staphylococcus aureus. Antibiotic resistance of S. aureus is a constant challenge for clinicians who manages atopic dermatitis.
Aim: To determine S. aureus antibiotic resistance pattern among patients with non-infected atopic dermatitis and its association with disease severity.
Methods: One hundred and seventy eight participants (89 AD patients and 89 controls) were recruited from Universiti Malaya Medical Centre (UMMC). Participants were subjected to a questionnaire on demographics, personal and family medical conditions as well as antibiotic administration. AD severity were determined using Scoring Atopic Dermatitis (SCORAD). Skin swab was taken from eczematous lesion in patients and from left forearm in controls. Antibiotic susceptibility towards methicillin, vancomycin, rifampicin, fusidic acid, erythromycin, gentamicin, clindamycin, sulphamethoxazole, cefuroxime and penicillin were determined using disk diffusion method. Results for antibiotic resistance were categorized as none, sensitive and resistant.
Results: Colonization of S. aureus in AD were significantly higher than control (p<0.001). Highest antibiotic resistance was reported for Penicillin (32/39, 82.1%), followed by Fusidic Acid (7/39, 17.9%) as well as Clindamycin and Erythromycin (3/39, 7.7% respectively). Two AD patient (5.1%) were resistant to Gentamicin. In addition, 1 AD patient (2.6%) was resistant towards Methicillin, Sulfamethoxazole and Cefuroxime respectively. No antibiotic resistance was reported for Vancomycin and Rifampicin among the AD patients.
Conclusion: High resistance were found for Penicillin and Fusidic acid. Their usage and prescription should be reduced to preserve its sensitivity.
3.Anxiety and Depressive Symptoms and Coping Strategies in NAsopharyngeal Carcinoma Patients in Hospital Kuala Lumpur
KO Noor Jan Naing ; AA Nor Azillah ; I Nooriny ; CH Tan ; YY Yeow ; A Hamidin
Malaysian Journal of Medicine and Health Sciences 2010;6(1):71-81
Introduction: Nasopharyngeal Carcinoma(NPC) is the second most common cancer among men in Malaysia. Establishing local data will help to improve the treatment strategies and lower the anxiety and depression level among NPC patients. Our aim was to compare the level of symptoms of anxiety and depression and the coping strategies employed between NPC and cancer-free patients. Methods: A comparative cross-sectional study with universal sampling was conducted on 22 NPC patients and 30 cancer0free patients from the Oncology and Radiotherapy Department and Ear,Nose and Throat clinic of Hospital Kuala Lumpur (HKL) between 12 to 29 May 2008. In this study, the symptoms of depression and anxiety were obtained by using the Hospital Annxiety and Depression Scale (HADS) while Brief COPE questionnaire was used to understand patients' coping strategies. Results: The prevalence of NPC was higher in the Chinese, men,aged between 40 and 59 years, and those from the lower income group. The levels of anxiety and depression symptoms were found to be higher in the NPC group as compared to the cancer-free group. However, only the level of depression was found significantly related to the NPC group (p=0.002) This study also found that the two comparison groups were using different types of coping strategies. The NPC patients mainly used 'acceptance' as their coping strategy while the comparative group most often used 'religion'. Among the types of coping strategies reported by the patients, 'use of instrumental support' type was found to be associated with a lower level of anxiety (p=0.035) and 'humour' type was associated with lower depressive symptoms (p=0.269). On the contrary, 'self-blame' type was associated with both anxiety (p=0.0001) and depression (p=0.001) symptoms. In addition, patients with different gender, ethnicity, educational levels, and monthly income were also found to have significant differences in their levels of anxiety and depression as well as type of coping strategies. Conclusions: NPC patients had higher anxiety and depression levels as compared to the comparative group. Different socio-demographic backgrounds and different types of coping strategies had an influence on patients resulting in different levels of anxiety and depression
4.Knee and ankle ligaments: magnetic resonance imaging findings of normal anatomy and at injury.
Seng Choe THAM ; Ian Yy TSOU ; Thomas Sg CHEE
Annals of the Academy of Medicine, Singapore 2008;37(4):324-329
Ligamentous injuries of the lower limb are a common entity sustained during sports activities and military training. Magnetic resonance (MR) imaging of the knee and ankle is playing an increasingly important role in the detection, diagnosis and prognosis of these injuries and their associated complications. MR imaging with its exquisite soft tissue contrast resolution and multiplanar capability is increasingly seen as the modality of choice for evaluating ligamentous injuries of the knee and ankle. Representative knee and ankle MR studies from a tertiary referral hospital are used to illustrate both the normal appearance and typical radiological features of common ligamentous injuries of the knee and ankle. A thorough understanding of the MR appearances of these injuries is crucial to the radiologist and clinicians involved in the management of these patients.
Ankle Injuries
;
diagnosis
;
Athletic Injuries
;
Humans
;
Knee Injuries
;
diagnosis
;
Ligaments, Articular
;
injuries
;
physiopathology
;
Magnetic Resonance Imaging
6.Environmental and Occupational Health Impact of Bauxite Mining in Malaysia: A Review
Lee KYa, Ho LY ; Tan KH ; Tham YY ; Ling SP ; Qureshi AM ; Ponnudurai T ; Nordin R ; Jeffrey Cheah
The International Medical Journal Malaysia 2017;16(2):137-150
In the perspective of recent bauxite mining in Malaysia, this review aims to identify the potential
environmental and health impacts on miners and surrounding communities. The environmental issues of
bauxite mining include, air, water and soil pollution due to bauxite dust; leaching of bauxite into water
sources resulting in reduced soil fertility as well as affecting agricultural food products and aquatic life.
Bauxite occupational exposure affects the health of miners, and has negative consequences on the health of
surrounding communities, such as increased respiratory symptoms, contamination of drinking water, other
potential health risks from ingestion of bauxite and heavy metals, including noise-induced hearing loss and
mental stress. This review discusses the processes of bauxite mining, its constituents and residual trace
elements, and their impact on the environment and health of exposed workers and communities. It also
explores the Malaysian legal requirements and standards of occupational exposure to bauxite.
8.Survey of Respiratory Virus in Patients Hospitalised for Acute Exacerbations of Heart Failure - A Prospective Observational Study.
Candice Yy CHAN ; Jenny Gh LOW ; Wyiki WYONE ; Lynette LE OON ; Ban Hock TAN
Annals of the Academy of Medicine, Singapore 2018;47(11):445-450
INTRODUCTION:
Respiratory virus (RV) infections have been implicated in acute exacerbation cardiopulmunary conditions. This study aimed to determine the prevalence of RV infections in patients admitted to the cardiology unit with acute decompensated heart failure (ADHF) in a tertiary hospitals in Singapore.
MATERIALS AND METHODS:
This was a single-centre, prospective observational study. A total of 194 adults (aged >21) admitted to the Singapore General Hospital with ADHF were recruited. A nasopharyngeal swab was taken for multiplex polymerase chain reaction (PCR) detection of influenza virus, rhinovirus, parainfluenza virus (HPIV), human coronavirus (HcoV), adenoviurs, human bocavirus (HboV), human metapneumovirus (hMPV), and respiratory syncytial virus (RSV).
RESULTS:
Twenty-five (13%) had RVs detected by RV multiplex PCR. There comprised 9 rhinoviruses (36%), 4 influenza A viruses (16%), 3 HPIV (12%), 3 HCoV (12%), 2 adenoviruses (8%), 1 human HBoV (4%), 1 hMPV (4%), and 1 RSV (4%). Symptoms-wise, cough was significantly more common in the PCR-positive group (48% vs 24%, = 0.02). There were no statistically significant differences in laboratory investigations (haemoglobin, leukocytes, platelets, creatine kinase, creatine kinase-muscle/brain, troponin T), and radiology findings between RV PCR-positive and -negative groups. The PCR-positive group did not have increased mortality or length of hospital stay.
CONCLUSION
This study identified a considerable burden of RVs in our ADHF cohort, and highlights the need for prevention of RVs in this group of patients. We also recognised the difficulty with clinical diagnosis of RVs in ADHF patients.
Adult
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Comorbidity
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Diagnosis, Differential
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Female
;
Heart Failure
;
epidemiology
;
physiopathology
;
therapy
;
Humans
;
Length of Stay
;
statistics & numerical data
;
Male
;
Nasopharynx
;
virology
;
Outcome Assessment (Health Care)
;
Prospective Studies
;
Respiratory Tract Infections
;
epidemiology
;
therapy
;
virology
;
Singapore
;
epidemiology
;
Survival Analysis
;
Symptom Flare Up
;
Viruses
;
classification
;
isolation & purification
;
pathogenicity
9.Successful Replantation Despite Improper Storage of Amputated Thumb: A Case Report
Gunasagaran J ; Tan YY ; Ahmad TS
Malaysian Orthopaedic Journal 2022;16(No.1):122-125
Replantation of fingers is highly complex and technically
challenging. Surgeons are serious with their selection criteria
as many factors are involved in determining good surgical
outcome. Improper storages of amputated parts are usually
denied the option for replantation. We report a 42-year-old
lady who was assaulted with a machete and presented with
total amputation of left thumb. The amputated thumb was
stored in a plastic bag directly on ice cubes which eventually
melted; thumb immersed in water for two hours. On
examination, the amputated thumb was neither macerated
nor frozen. Replantation was attempted and was successful.
There are limited reports on proper methods of storage of
amputated fingers pertaining to daily practical scenario. Yet,
it is a strict criterion for surgeons in attempting replantation.
Direct contact of amputated fingers on ice and immersion in
hypotonic solutions leads to irreversible tissue damage. In
our case, two hours of unfavourable storage did not affect
surgical outcome. In conclusion, clinical assessment of the
amputated part is essential in deciding for replantation.
Combination of direct contact with ice and immersion in
hypotonic solution for two hours should not be a
contraindication for replantation.
10.Multiple Accessory Cusps Expression at Mandibular Third Molar: A Unique Variation of Dental Crown Morphology - A Case Report
Nur Lyanna Mahfuzah Mohamad Johar ; Yy Jean Tan
Annals of Dentistry 2023;30(No.1):17-21
Accessory cusps are occasional variations in tooth morphology that can be detected clinically. Third molars
have a wide range of eruption patterns and shapes but are commonly impacted. Unlike root morphology,
variations in the crown morphology of the third molar have rarely been reported. Variations in crown
morphology are important because they can affect clinical outcomes. Here, we present a rare case of fully
erupted mandibular third molar (MTM) with multiple accessory cusps. This case report describes a case of a
31-year-old female Kenyah with a unique crown morphology of her fully erupted, vital, and functional
mandibular third molar (MTM) which has multiple accessory cusps seen on the buccal surface, giving the
appearance of a double tooth. Her MTM presented with an incipient caries lesion, which was managed
conservatively. Documenting variations in tooth morphology is crucial for individual identification. While most
people opt to have their MTMs extracted, early management of well-erupted and functional teeth should be
undertaken to prevent disease progression.