1.Anti-N-methyl-D-aspartate receptor (NMDAR) Encephalitis in Malaysia: A Review Article
Su Tein Sim ; Peck Kee Chia ; Keng Hong Chhoa ; Bin Shen Chai
Malaysian Journal of Medicine and Health Sciences 2021;17(No.1):163-169
N-methyl-D-aspartate receptor (NMDAR) antibody encephalitis is recognized as an autoimmune encephalitis, which
is due to autoantibodies against synaptic NMDAR. This disorder affects individuals aged 23 months to 76 years and
has a wide range of presentations. In Malaysia, more than 20 cases have been reported. Timely diagnosis and definitive immunotherapy are vital in optimizing functional recovery and prognosis. However, early diagnosis of the
condition is often missed due to low awareness among clinicians in Malaysia. This article gathered the medical literature from Malaysia and highlights the aetio-pathophysiology, clinical presentation and management of the disease.
2.Longitudinal Extensive Transverse Myelitis as a Neurological Sequelae post-Sea Urchin Stings: A Case Report
Anas Aminin W M Izzuddin ; Abdul Hanif Khan Yusof Khan ; Liyana Najwa Inche Mat ; Laila Mastura Ahmad Apandi ; Peck Kee Chia ; Hamidon Basri
Malaysian Journal of Medicine and Health Sciences 2021;17(No.1):187-190
Puncture injury from sea-urchin stings may lead to a local and systemic inflammatory reaction. We are reporting a
case of longitudinal extensive transverse myelitis (LETM), which occurred ten days post-sea-urchin stings, where the
patient presented with bilateral lower limb weakness. MRI showed multilevel segment spinal cord T2-weighted hyperintensity. Prompt intravenous methylprednisolone was administered, and the patient had a full recovery. To date,
there is no case report of LETM associated with sea-urchin stings. Possible mechanism due to delayed immunological
hypersensitivity to sea-urchin venom. This case demonstrates the potential serious neurological sequelae that may be
associated with post-sea-urchin sting and the importance of prompt recognition and management in aiding recovery.
3.Safety and Efficacy of Dabigatran Versus Warfarin in Asian Patients With Atrial Fibrillation
Liyana Najwa Inche Mat ; Ooi Qi Wen ; Nurul Natasha Ashikin Johari ; Rooban Raao Subramaniam ; Wan Aliaa Wan Sulaiman ; Hoo Fan Kee ; Chia Peck Kee ; Hamidon Basri
Malaysian Journal of Medicine and Health Sciences 2020;16(No.4):89-95
Introduction: Nonvalvular atrial fibrillation is a common cause of cardioembolic stroke which accounts around
50% of all cardioembolic emboli. Oral anticoagulants remain the main choice of stroke prevention in patients with
atrial fibrillation. Our study is aimed to determine the safety (absence or presence of bleeding events) and efficacy
(absence or presence of ischemic stroke occurrence) of dabigatran versus warfarin for stroke prevention in patients
with nonvalvular atrial fibrillation. Methods: A retrospective audit study was conducted based on past data obtained
from Electronic Hospital Information System (EHIS) records in Serdang Hospital. Our sample was 150 patients with
nonvalvular atrial fibrillation who were at risk of getting stroke and being prescribed with oral anticoagulants either
warfarin or dabigatran from the year 2013 until 2019. Results: Our study showed that there was lesser occurrence
of ischemic stroke in patients from dabigatran group (1.3%) as compared to those in warfarin group (2.7%). There
were also almost 2 times lesser bleeding events in dabigatran group (6.7%) as compared to those in warfarin group
(14.7%). The median of CHA2DS2-VASc Score in warfarin sampled patients (median=3+/-1) was lower than dabigatran sampled patients (median=4+/-1). Conclusion: Both warfarin and dabigatran are effective in preventing stroke
for patients with nonvalvular atrial fibrillation. However, dabigatran is associated with lesser bleeding events with
lower incidence of major bleeds compared to warfarin.
4.Regional Emergency Stroke Quick-Response (RESQ) Network: A Proposed Paradigm of Malaysia Stroke Care Services
Peck Kee Chia ; Nur Afiqah Mohamad ; Liyana Najwa Inche Mat ; Iskasymar Itam@Ismail ; Abdul Hanif Khan Yusof Khan ; Wei Chao Loh ; Wan Aliaa Wan Sulaiman ; Fan Kee Hoo ; Ezamin Abdul Rahim ; Ahmad Sobri Muda ; Hamidon Basri
Malaysian Journal of Medicine and Health Sciences 2020;16(No.4):353-361
Stroke care service in Malaysia is suboptimal despite the fact that it is one of the commonest cause of death. This
is due to several limitations, including lack of resources and funding for the stroke care establishment and the management itself. Alternatively, other regions have come up with numerous ways to combat the difficulties in order
to provide better stroke care services. We have identified the overwhelming benefits of creating stroke care units,
thrombolysis services, and endovascular thrombectomy. For this reason, we designed a Regional Emergency Stroke
Quick Response Network (RESQ) based on the needs of the current situation in Malaysia. With a standardised RESQ
training, we hope to achieve close-knitted cooperation in between the emergency medical services, emergency department team and the RESQ, which subsequently will create an ideal improvised stroke care units.
5.Coronavirus Disease-2019: Knowledge and Practices Behaviour of Healthcare Workers at a University Teaching Hospital in Malaysia
Kai Wei Lee ; Abdul Hanif Khan Yusof Khan ; Siew Mooi Ching ; Navin Kumar Devaraj ; Janudin Baharin ; Peck Kee Chia ; Wei Chao Loh ; Anna Misya' ; il Abdul Rashid ; Liyana Najwa Inche Mat ; Wan Aliaa Wan Sulaiman ; Mohd Tawfeq Mohd Noor ; Dhashani Sivaratnam ; Fan Kee Hoo ; Hamidon Basri
Malaysian Journal of Medicine and Health Sciences 2021;17(No.3):149-158
Introduction: Coronavirus disease-2019 (COVID-19) was declared a global pandemic in March 2020, with 15 million people have been infected worldwide, and this number is increasing. Our study sought to assess the knowledge
and practice of healthcare workers (HCWs) in a teaching hospital in Malaysia. Methods: This cross-sectional study
was undertaken using online Google form links among HCWs. Knowledge and practice were assessed using a validated questionnaire. The analysis was performed with SPSS version 26. Factors associated with poor knowledge
were analysed using multivariate analysis. Results: A total of 193 HCW responded to our online survey. Majority of
our HCWs were female (74.1%) with a mean age of 32.5 years. We found 53 (27.5%) and 134 (69.4%) of our HCWs
had good knowledge and good practice on COVID-19, respectively. Knowledge gap was identified in the symptomatology, investigation methods and management. Based on multiple logistic regression, determinants of poor knowledge scores were those work as medical attendants (aOR = 3.626; 95% CI = 1.489, 8.834) and nurses (aOR = 4.107;
95% CI = 1.175, 14.358). Conclusion: Around one-third and 70% of our HCWs have good knowledge and practice
of COVID-19 infection respectively. Continuous, specifically targeted and updated medical education, need to be
carried out to improve the knowledge and practice among our HCWs in order to keep abreast of the fast-moving
pace of COVID-19 knowledge development.