1.A Review of Coronary Artery Disease Research in Malaysia
Ang Choon Seong ; Chan Kok Meng John
The Medical Journal of Malaysia 2016;71(3 Suppl.):42-57
Coronary artery disease is the major cause of mortality and
morbidity in Malaysia and worldwide. This paper reviews all
research and publications on coronary artery disease in
Malaysia published between 2000-2015. 508 papers were
identified of which 146 papers were selected and reviewed
on the basis of their relevance. The epidemiology, etiology,
risk factors, prevention, assessment, treatment, and
outcomes of coronary artery disease in the country are
reviewed and summarized. The clinical relevance of the
studies done in the country are discussed along with
recommendations for future research.
Coronary Artery Disease
2.Treatments of Infra-Orbital Dark Circles by Various Etiologies.
Kui Young PARK ; Hyun Jung KWON ; Choon Shik YOUN ; Seong Jun SEO ; Myeong Nam KIM
Annals of Dermatology 2018;30(5):522-528
Dark circles refer to visible darkness of the infra-orbital areas. Dark circles are a cosmetic concern for many individuals, although not a medical concern. Moreover, clear definitions and possible causes of dark circles have not been elucidated. This study reviews the possible causes and treatment options for dark circles based on a review of the medical literature and the authors' clinical experience. Potential factors that contribute to dark circles include excessive pigmentation, shadowing due to tear troughs and infra-orbital fat herniation, shadowing due to infraorbital laxity and wrinkles, and thin, translucent skin overlying the orbicularis oculi muscle. Given the different possible causes for dark circles, therapeutic modalities must be individualized for each patient. Because various factors cause dark circles, it is useful to identify the underlying causes in order to select the appropriate treatment.
Darkness
;
Humans
;
Pigmentation
;
Shadowing (Histology)
;
Skin
;
Tears
3.The prevalence of advanced liver fibrosis among patients with type 2 diabetes mellitus: A single-centre experience in Penang, Malaysia
Xe Hui Lee ; Lisa Mohamed Nor ; Choon Seong Ang ; Toh Peng Yeow ; Shueh Lin Lim
Journal of the ASEAN Federation of Endocrine Societies 2023;38(1):52-61
Objectives:
This study aimed to compare the severity of COVID-19, inflammatory parameters and clinical outcomes
among patients with normal and subnormal levels of Vitamin D.
Methodology:
This is a retrospective cohort study of 135 patients admitted in a tertiary hospital for COVID-19. Patients
were grouped according to their Vitamin D level. Primary outcome measure was the composite of all-cause mortality and
morbidity. Other outcome measures determined were the comparison among the groups on the severity of COVID-19
infection, changes in inflammatory parameters, length of hospital stay and duration of respiratory support.
Results:
There was a significant trend of higher ICU admission, mortality (p-value= 0.006) and poor clinical outcome
(p-value=0.009) among the Vitamin D deficient group. No significant difference was found for most of the inflammatory
parameters, duration of hospital stay and respiratory support. Overall, patients with deficient, but not insufficient Vitamin
D level had 6 times higher odds of composite poor outcome than those with normal Vitamin D (crude OR=5.18, p-value=
0.003; adjusted OR =6.3, p-value=0.043).
Conclusion
The inverse relationship between Vitamin D level and poor composite outcome observed in our study
suggests that low Vitamin D may be a risk factor for poor prognosis among patients admitted for COVID-19.
type 2 diabetes mellitus
;
Non-alcoholic Fatty Liver disease
4.Misdiagnosis of community-acquired pneumonia in patients admitted to respiratory wards, Penang General Hospital
Ang Choon Seong ; Kelvin Beh Khai Meng ; Yeang Li Jing ; Chin Yuen Quan ; Khor Inn Shih ; Yoon Chee Kin ; Irfhan Ali bin Hyder Al
The Medical Journal of Malaysia 2020;75(4):390-
Introduction: Pneumonia continues to be as one of the top
causes of hospitalisations and deaths in Malaysia despite the
advancement in prevention and treatment of pneumonia. One
of the possible explanations is the frequent misdiagnosis of
pneumonia which had been reported elsewhere but such data is
not available locally.
Objectives: This is an audit project aiming to evaluate the
proportion of misdiagnosis among hospitalised communityacquired pneumonia (CAP) patients in the Respiratory wards
of Penang General Hospital based on their initial presentation
data, and their associated outcomes.
Methods: We reviewed the medical notes and initial chest
radiographs of 188 CAP patients who were admitted to
respiratory wards. Misdiagnosis was defined as cases which
lack suggestive clinical features and/or chest radiograph
changes. In-hospital mortality and length of stay (LOS) were
the outcomes of interest.
Results: The study found that 38.8% (n=73) of the hospitalised
CAP patients were misdiagnosed. The most common
alternative diagnosis was upper respiratory tract infection
(32.8%, n=24). There was no statistical difference between
misdiagnosis and CAP patients in the demographic and clinical
variables collected. In terms of outcomes, misdiagnosed
patients were discharged earlier (mean LOS= 3.5±3.28 days vs.
7.7±15.29 days, p=0.03) but the in-hospital mortality difference
was not statistically significant (p=0.07).
Conclusions: One third of our CAP admissions were
misdiagnosed. Although initial misdiagnosis of CAP in our
study did not show any increase in mortality or morbidity, a
proper diagnosis of CAP will be helpful in preventing
inappropriate prescription of antibiotics and unnecessary
admission.