1.Morel-Lavallee Lesion: A Forgotten Cause of Bleeding in Trauma
Medicine and Health 2017;12(2):363-367
The Morel-Lavallee lesion is a rare soft tissue injury that occurs due to traumatic shearing force on skin surface causing separation of skin and subcutaneous tissue resulting in hematoma. This case report depicts a 22-year-old gentleman who was involved in a motor vehicle accident. He complained of pain and swelling over lower back. He was treated for soft tissue injury and admitted for pain control. One day post-trauma, he complained of increased swelling over the back. His hemoglobin dropped from 12.2g/dL to 10.7g/dL. Diagnosis of Morel-Lavallae lesion was made. Initially no surgical intervention was planned. However, in view of worsening of swelling, bedside aspiration was performed and subsequently a pigtail catheter was inserted to drain the hematoma. In total, 2.05 litre of liquefied hematoma was drained. Thus, Morel-Lavallee lesion is an uncommon soft tissue injury that can cause significant bleeding following trauma.
2.Nutritional Status of Children below Five Years in Malaysia: Anthropometric Analyses from the Third National Health and Morbidity Survey III (NHMS, 2006)
Khor GL ; Noor Safiza MN ; Jamalludin AB ; Jamaiyah H ; Geeta A ; Kee CC ; Rahmah R ; Alan Wong N F ; Suzana S ; Ahmad AZ ; Ruzita AT ; Ahmad FY
Malaysian Journal of Nutrition 2009;15(2):121-136
The Third National Health and Morbidity Survey (NHMS III) was conducted in 2006 on a nationally representative sample of population in Malaysia. Over
21,000 children aged 0-17.9 years were measured for body weight and stature according to the protocol of the World Health Organization. This article describes
the nutritional status of children aged 0-59.9 months. Mean z score for weightfor-age (WAZ), height-for-age (HAZ) and BMI-for-age were compared with the
z-scores tables of the WHO standards. The overall prevalence of underweight
and stunting of the children were 12.9% and 17.2% respectively. These levels
included 2.4% severe underweight and 6.0% severe stunting. In terms of z scores,
the age group of 0–5.9 months showed the best nutritional status with mean
WAZ of -0.33 (95%CI: -0.52, 0.15) and -0.40 (-0.57, 0.24) for boys and girls
respectively, while mean HAZ was 0.64 (0.38, 0.89) for boys and 0.76 (0.54, 0.98)
for girls. Mean HAZ and WAZ status was least satisfactory after about 6 months,
suggesting a faltering in growth rate at an age that coincides with dependence on
complementary feeding. Prevalence of overweight based on BMI-for-age for the
sexes combined was 6.4%, while that based on WAZ was 3.4%. The NHMS III results indicate that Malaysian children have better nutritional status compared
to children under 5 years in neighbouring countries. In order to meet the targets set in the National Plan of Nutrition (2006-2015), more effective intervention
programmes are needed to accelerate the reduction of underweight and stunting, and to arrest the rise of overweight in young children.
3.Abdominal Obesity in Malaysian Adults: National Health and Morbidity Survey III (NHMS III, 2006)
Kee CC ; Jamaiyah H ; Noor Safiza MN ; Geeta A ; Khor GL ; Suzana S ; Jamalludin AR ; Rahmah R ; Ahmad AZ ; Ruzita AT ; Wong NF ; Ahmad Faudzi Y
Malaysian Journal of Nutrition 2008;14(2):125-135
Abdominal obesity (AO) is an independent risk factor for cardiovascular disease, hypertension and diabetes mellitus in adults. There is a lack of data on the
magnitude and socio-demographic profile of AO among Malaysian adults at the national level. In the Third National Health and Morbidity Survey (NHMS III)
conducted in 2006, AO of adults aged 18 years and above was determined based on the waist circumference as part of the nutritional status assessment. This
article reports the prevalence of AO in relation to socio-economic factors and demographic characteristics of adult subjects. Out of a total of 33,465 eligible
individuals 18 years and above, waist circumference was measured in 32,900 (98.3%) individuals. The prevalence of AO was assessed using the cut-off points
recommended by World Health Organization. The mean waist circumference in men and women was 84.0cm [95% confidence interval (95% CI): 83.8, 84.3] and
80.3cm (95% CI: 80.1, 80.6) respectively. The national prevalence of AO was 17.4% (95% CI: 16.9, 17.9). The identified risks of AO were women (OR: 4.2, 95%
CI: 3.8, 4.6), aged 50-59 years (OR: 5.6, 95% CI: 4.0, 7.7), Indians (OR: 3.0, 95% CI:2.4, 3.8), housewives (OR: 1.4, 95% CI: 1.1, 1.7), subjects with primary education
(OR: 1.3, 95% CI: 1.1, 1.5) and ever married (OR: 1.4, 95% CI: 1.2, 1.6). Being the largest population-based study on AO among Malaysians, these findings have
important public health implications. There is an urgent need to revise public health policies and programmes aimed at prevention of abdominal obesity especially in the groups at risk.