1.Human immunodeficiency virus and respiratory disorders: clinical and diagnostic considerations.
Papua New Guinea medical journal 2010;53(3-4):169-175
Respiratory infections are a major health burden for the people of Papua New Guinea (PNG) who are positive for human immunodeficiency virus (HIV). In the face of an ongoing HIV epidemic, little is known about the epidemiology and aetiology of respiratory infections in people living with HIV in PNG. In this article we provide an overview of the most important respiratory pathogens in HIV-positive people globally, focusing primarily on adults. Particular attention is given to respiratory viruses, bacterial pathogens such as Streptococcus pneumoniae and Mycobacterium tuberculosis, and Pneumocystis jiroveci. In doing so we highlight the need for a better understanding of the aetiology of respiratory infections in HIV-positive people in PNG. A study is underway that aims to determine the aetiology of common infectious illnesses in HIV-positive people in PNG, focusing on respiratory infections, diarrhoeal diseases and febrile illness. The results of this study should guide future prevention, diagnostic and treatment strategies.
2.Clinical Result of Surgical Treatment of the Idiopathic Club Foot
SH LEE ; SW SUH ; WJ LEE ; SJ HONG
The Journal of the Korean Orthopaedic Association 1996;31(3):418-425
Authors reviewed clinical results of idiopathic club foot, of 52 patients have been treated by surgery and followed up more than 2 years at the Department of Orthopaedic Surgery, Korea University, Guro Hospital in order to evaluate the results after surgery for idiopathic club foot and the best time for surgical management. Materials consist of 3 groups regarding the surgical regimen:Group I was of one-stage postermedial release(58 feet/36 patients), Group II of posterolateral release(11 feet/7 patients)and Group III of Lichtblau osteotomy(10 feet/9 patients). Assessment was made by the radiologic(Beatson and Ponsenti's)and clinical(Preson and Fell's)criterias. From the review the following observations were obtained: 1. Percentage of the surgically treated feet was 30% in author's series(97 feet/327 feet). 2. The mean age at the operation was 1 year 11 months in group I, 1 year 11 months in group II, 6 years 2 months in group III and 3 years 4 months(2 months – 12 years) in all groups. 3. The clinical results evaluated by Preston's method were good in 32 feet(55%), fair in 16 feet(28%), poor in 10 feet(17%) for the group I, 58 feet and good in 4 feet(36%), fair in 4 feet(36%), poor in 3 feet(28%) for the group II, 11 feet and good in 6 feet(60%), fair in 2 feet(20%), poor in 2 feet(20%) for the group OOO, 10 feet. 4. The radiologic results evaluated by Beatson and Posenti's criteriae were good in 44 feet(55%), fair in 18 feet(23%), poor in 17 feet(22%) in all groups. 5. The success rate of primary surgical treatment for idiopathic club foot was 81% in all groups and 83% in PMR group. 6. Regarding age at operation, the best result was showed between 1 and 2 years old in PMR group. In conclusion, the surgery was the satisfactory method for the treatment of idiopathic club foot and the posteromedial release was showed better results than the posterolateral release group. Results according to age at operation in PMR group, the best results obtained between 1 year and 2 years old. The results in posterolateral release group was poor because the forefoot adduction deformity was persistant.
Congenital Abnormalities
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Foot
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Humans
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Korea
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Methods
3.Efficacy of tadalafil for erectile dysfunction: an updated review.
National Journal of Andrology 2007;13(6):568-572
Tadalafil is an effective drug in treating erectile dysfunction (ED), and its clinical efficacy has been confirmed by a great many researches. Tadalafil is distinguished from sildenafil and vardenafil by its prolonged action lasting 36 hours for a sigle dose, compared with about 4 hours for sildenafil. Furthermore, this drug is effective in improving the erectile function of ED patients including those with various comorbid conditions. Tadalafil can help ED patients to regain morning erection and recover the confidence as a man. More and more ED patients choose tadalafil as the first line therapy because of its long efficacy and its conformability to the therapeutic requirement by restoring ED patients to normal, natural and pleasurable sexual life.
Carbolines
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therapeutic use
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Erectile Dysfunction
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drug therapy
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Humans
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Male
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Tadalafil
4.The 28-Day Mortality Prediction in Sepsis Patients Using Static Lactate Concentration and Early Lactate Clearance: An Observational Study
Tan TL ; Noor Asmidar A ; Ong WJ ; Ahmad Fuad Fahmi MN ; Chieng ZL ; Akmal SI
Medicine and Health 2014;9(2):124-133
Sepsis causes high mortality and morbidity. Static lactate concentration and early lactate clearance are cited to be a predictor for sepsis survival. This study examined the clinical utility of static lactate concentration and early lactate clearance within the first six hours of admission in Emergency Department (ED) to predict 28-day mortality rate in sepsis patients. Patients who presented with sepsis, severe sepsis or septic shock and admitted to ED of Universiti Kebangsaan Malaysia Medical Centre were recruited. Blood lactate concentrations were measured upon admission (H0), at 1st hour (H1) and 6th hour (H6), respectively. Either standard treatment of sepsis or early goal directed therapy was initiated according to sepsis severity. A follow-up report was conducted at 28 days via telephone call, e-mail or case notes. Patients were later classified into survivor and non-survivor as final outcome. Static lactate concentration appeared to be significantly higher for non-survivor as compared to the survival group at H0, H1 and H6 (p<0.05). The lactate clearance trend reflects no relationship between early lactate clearance and 28-day mortality. Static lactate
concentration showed a superior predictor for sepsis over early lactate clearance. Although early lactate clearance was unable to prove its ability to predict 28-day mortality, our findings suggest it can be a useful tool to gauge the resuscitation outcome.
Sepsis
5.Bacteraemia in Haematopoietic Stem Cell Transplant Recipients in a Single Tertiary Referral Centre
NURUL IMAN P ; RAMLIZA R ; WAN FARIZA WJ ; SHAMSUL AZHAR S ; NOR AZIMAH I ; FADILAH SAW
Medicine and Health 2019;14(2):60-76
Bacteraemia is a common and one of the serious complications in haematopoietic stem cell transplantation (HSCT). To date, there are no published data on antibiotic resistance and clinical outcome among HSCT recipients in Malaysia. The aims of the present study was to analyse the prevalence, antibiotic resistance and clinical outcome of bacteraemia in HSCT recipients within 100 days following transplantation. We retrospectively analysed the prevalence, antibiotic resistance pattern and mortality rate of early bacteraemia among HSCT recipients in a single centre over a 5-year period (2013-2017). Thirty patients of 85 HSCT recipients developed bacteraemia with 40 positive cultures resulting in prevalence of 47% (40/85). Gram negative bacteria (GNB) accounted for 60.5% of total isolates. Enterobacteriaceae and Coagulase negative Staphylococcus (CoNS) were the commonest pathogens isolated. GNB showed a high resistance rate to ciprofloxacin. Only 30% of recipients responded to first line empirical antibiotics for febrile neutropenia (FN). The mortality rate was 13.3% (4/30), of which 50% was attributed to multi-drug resistance (MDR) Acinetobacter and 25% to extended spectrum beta-lactamase (ESBL) Enterobacteriaceae. Bacteraemia is a frequent and life-threatening early complication among HSCT recipients with MDR GNB being the commonest cause of mortality. The high rate of resistance to ciprofloxacin and failure of the first line empirical antibiotics to treat FN calls for a thorough evaluation of the current antibiotic prophylaxis and empirical treatment protocols. These findings have important clinical implications regarding the use and selection of both prophylactic and empiric antibiotic regimens to treat FN.
6.Breast cancer with dermatomyositis as initial presentation
The Medical Journal of Malaysia 2018;73(1):44-45
Patients with breast cancer normally present with breastlump or abnormal mammogram. Dermatomyositis is rarelythe first presentation. We present a case of a 63-year-oldwoman who had generalised dermatitis, progressive fatigueand muscle weakness. She was first diagnosed asdermatomyositis and subsequently breast cancer. Her rashand muscle weakness progressed drastically over a month.Tumescent mastectomy and axillary surgery was performed,which led to gradual regression of her dermatomyositis oversix months. This case report emphasized in the benefit ofearly diagnosis and treatment of dermatomyositis andbreast cancer. Pros and cons of tumescent mastectomy isdiscussed as well.
8.Tadalafil for erectile dysfunction: excellent safety and tolerance.
National Journal of Andrology 2009;15(1):92-95
As a novel phosphodiesterase type 5 (PDE5) inhibitor, tadalafil is administered orally for the treatment of erectile dysfunction (ED). In addition to its outstanding efficacy that lasts 36 hours, tadalafil shows an excellent safety and tolerance, with only a few transient mild to moderate adverse events. Usually ED patients are concomitantly afflicted with multiple pre-existing medical conditions or receive a range of drugs at the same time. Therefore, it is essential to understand its safety in general population and some special high-risk cohorts.
Carbolines
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adverse effects
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therapeutic use
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Drug Tolerance
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Erectile Dysfunction
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drug therapy
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Humans
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Male
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Phosphodiesterase Inhibitors
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adverse effects
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therapeutic use
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Tadalafil
9.Androgen regulates penile erection at the peripheral level.
National Journal of Andrology 2006;12(12):1059-1062
Androgen has been claimed for so long as a pivotal hormone in regulating male sexual function, acting both at the central and peripheral level. We believe that androgen is indeed the main synchronizer of sexual activity regulating libido and enzymes as nitric oxide synthase (NOS) and phosphodiesterase type 5 ( PDE5) , which are crucial for the erectile process. The main action of androgen is to timely adjust the erectile process as a function manifestation of sexual desire, therefore finalizing erection to sex.
Androgens
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pharmacology
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physiology
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Animals
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Male
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Nitric Oxide Synthase
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metabolism
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Penile Erection
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drug effects
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physiology
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Phosphoric Diester Hydrolases
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metabolism
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Rats
10.Patient-Related Barriers to Cancer Pain Management – A Prospective Cross Sectional Study in a Tertiary Hospital
Choy YC ; Wan Nuruddin Shah WJ ; Wong YM ; Boey CY ; Noor Zuhaily MN ; Kumutha T ; Juliana J
Journal of Surgical Academia 2013;3(1):7-12
Effective management of cancer pain is often hampered by patients’ lack of knowledge regarding cancer pain
management and other barriers related to ethnicity and religious beliefs. This cross sectional study was
performed to determine the patient-related barriers to effective cancer pain management. One hundred patients
receiving cancer pain management were studied. Inclusion criteria were: patients over the age of 18 years, able
to communicate, with known diagnosis of cancer, experiencing persistent pain for the past two weeks. A
modified version of the Barriers Questionnaire II (BQ-II) was used and a modified Brief Pain Inventory was
used to assess the pain profile. Barriers such as, patient’s attitude and beliefs, communication skills and fear of
side effects of pain medication were determined, given a score and the summation was recorded as the total
patient related barriers score. Overall, 85% of respondents achieved more than 40% pain relief and the 72 of 100
patients reported low patient related barrier scores of 6 or less. Nevertheless, the main patient related barriers
were: fear of tolerance to opioids (51%), ethnicity (p=0.003) and religious beliefs (p=0.002) which constituted
the major components of the patient-related barriers score. Ethnicity and religious beliefs had significant
influence on patient-related barriers score suggesting the need of further investigation into this area. In order to
achieve a comprehensive view, other barriers to effective cancer pain management such as those related to the
health systems and healthcare providers need to be assessed together.