ABSTRACT Benign gastrojejunocolic fistula is mostly due to Bilroth II operations. It typically presents with a triad of feculent vomiting, weight loss and chronic diarrhoea but sometimes the diagnosis is not straight forward. We discuss a case that presented and was investigated as intestinal obstruction however diagnosed with gastrojejunocolic fistula during surgery. KEYWORDS: Gastrojejunocolic fistula, Bilroth II
摘要良性胃-空肠瘘主要是由Bilroth II手术引起的。它通常表现为不洁呕吐、体重减轻和慢性腹泻，但有时诊断并不直接。我们讨论了一个病例，该病例被诊断为肠梗阻，但在手术中被诊断为胃空肠瘘。关键词：胃空肠瘘，Bilroth II
{"title":"Gastrojejunocolic fistula: A case report","authors":"Khairussaleh Bj, Kyaw Th","doi":"10.31436/IMJM.V8I2.757","DOIUrl":"https://doi.org/10.31436/IMJM.V8I2.757","url":null,"abstract":"ABSTRACT Benign gastrojejunocolic fistula is mostly due to Bilroth II operations. It typically presents with a triad of feculent vomiting, weight loss and chronic diarrhoea but sometimes the diagnosis is not straight forward. We discuss a case that presented and was investigated as intestinal obstruction however diagnosed with gastrojejunocolic fistula during surgery. KEYWORDS: Gastrojejunocolic fistula, Bilroth II","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47460828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ABSTRACT Introduction: Diabetes is associated with a high risk of cardiovascular disease. The management of blood glucose, dyslipidaemia and other modifiable risk factor, is a key element in the multifactorial approach to prevent complications of type 2 diabetes. Materials and Methods: A cross sectional study was conducted to determine the level of glycaemic control, lipid profile, blood pressure and body weight status among type 2 diabetics in rural Malaysia. A total of 237 diabetic subjects participated in this study. Physical examination was carried out, including measurements of height, weight, waist and hip circumferences, and systolic and diastolic blood pressure. Fasting venous blood samples were collected to determine the glucose level and lipid profile. Results: About 70% of the subjects had a high body mass index (BMI), equal to or above 25 kg/ m2. More than 60% of the subjects had systolic blood pressure = 140 mmHg and/or diastolic = 90 mmHg. Mean fasting blood glucose was 9.84±4.54 mmol/L. Mean total cholesterol was 5.18±1.35 mmol/L. High density lipoprotein cholesterol (HDLC) and triglyceride (TG) and glucose levels were higher in male than in female, but not statistically significant (p>0.05). However, low density lipoprotein cholesterol (LDLC) was higher in females than males (p<0.05). Mean HDLC was below 1.0 mmol/L in all subjects. Conclusion: Glycaemic control, lipid profile, blood pressure and body weight status were not satisfactory and may increase the risk of microvascular and macrovascular complications among these subjects. Appropriate intervention programs should be implemented for better diabetes control among rural subjects. KEYWORDS: Diabetic control, Diabetes, Rural, Malaysia
{"title":"Glycaemic Control, Lipid Profile, Blood Pressure and Body Weight Status Among Diabetics in Rural Malaysia","authors":"H. As, Y. Zaitun, M. Kandiah, S. Chan","doi":"10.31436/IMJM.V8I2.753","DOIUrl":"https://doi.org/10.31436/IMJM.V8I2.753","url":null,"abstract":"ABSTRACT Introduction: Diabetes is associated with a high risk of cardiovascular disease. The management of blood glucose, dyslipidaemia and other modifiable risk factor, is a key element in the multifactorial approach to prevent complications of type 2 diabetes. Materials and Methods: A cross sectional study was conducted to determine the level of glycaemic control, lipid profile, blood pressure and body weight status among type 2 diabetics in rural Malaysia. A total of 237 diabetic subjects participated in this study. Physical examination was carried out, including measurements of height, weight, waist and hip circumferences, and systolic and diastolic blood pressure. Fasting venous blood samples were collected to determine the glucose level and lipid profile. Results: About 70% of the subjects had a high body mass index (BMI), equal to or above 25 kg/ m2. More than 60% of the subjects had systolic blood pressure = 140 mmHg and/or diastolic = 90 mmHg. Mean fasting blood glucose was 9.84±4.54 mmol/L. Mean total cholesterol was 5.18±1.35 mmol/L. High density lipoprotein cholesterol (HDLC) and triglyceride (TG) and glucose levels were higher in male than in female, but not statistically significant (p>0.05). However, low density lipoprotein cholesterol (LDLC) was higher in females than males (p<0.05). Mean HDLC was below 1.0 mmol/L in all subjects. Conclusion: Glycaemic control, lipid profile, blood pressure and body weight status were not satisfactory and may increase the risk of microvascular and macrovascular complications among these subjects. Appropriate intervention programs should be implemented for better diabetes control among rural subjects. KEYWORDS: Diabetic control, Diabetes, Rural, Malaysia","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43502038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ABSTRACT Patient with thyroid mass rarely presents in emergency situation. It is because the nature of the mass is that it usually increases slowly in size. Thus, any surgical intervention can be planned electively. The most common condition that necessitates urgent intervention, is upper airway compromise due to sudden rapid increase in size of the swelling. This can be due to intralesional bleeding or superimposed infection on the enlarged gland. We report a case of urgent completion thyroidectomy performed to a patient with fungating recurrent papillary carcinoma who present with bleeding from the mass externally. KEYWORDS: Bleeding, Recurrent papillary carcinoma, Thyroidectomy
{"title":"An Unusual Presentation of a Thyroid Malignancy: A Case Report","authors":"I. M., B. A, Ananda Dorai A","doi":"10.31436/IMJM.V9I1.743","DOIUrl":"https://doi.org/10.31436/IMJM.V9I1.743","url":null,"abstract":"ABSTRACT Patient with thyroid mass rarely presents in emergency situation. It is because the nature of the mass is that it usually increases slowly in size. Thus, any surgical intervention can be planned electively. The most common condition that necessitates urgent intervention, is upper airway compromise due to sudden rapid increase in size of the swelling. This can be due to intralesional bleeding or superimposed infection on the enlarged gland. We report a case of urgent completion thyroidectomy performed to a patient with fungating recurrent papillary carcinoma who present with bleeding from the mass externally. KEYWORDS: Bleeding, Recurrent papillary carcinoma, Thyroidectomy","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41894640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ABSTRACT Paragangliomas are uncommon tumors arising from the neuroendocrine elements (chief cells) of the paraganglia and symmetrically distributed along the aorta in close association with the sympathetic chain. Although functional tumors are easier to diagnose due to the clinical fi ndings caused by excess secretion of catecholamines and an elevation of the urinary catecholamine levels, however the diagnosis of nonfunctioning paraganglioma of the retroperitoneum is diffi cult and only few cases have been made before exploratory laparotomy. Although our patient was initially planned and operated by our gynaecological team, the incidental fi ndings had to involve the general surgeons. She is fortunate that the tumour did not show any features of malignancy nor metastasis, however a long time follow up is needed in case of any possible recurrence. KEYWORDS: Paraganglioma, Non-functioning, Retroperitonium
{"title":"An Undiagnosed Non Functioning Retroperitoneum Paraganglioma, Complicating A Gynaecological Surgery; A Case Report","authors":"A. Noraziana, B. Hakim, R. Alik, A. Mokhtar","doi":"10.31436/IMJM.V9I1.744","DOIUrl":"https://doi.org/10.31436/IMJM.V9I1.744","url":null,"abstract":"ABSTRACT Paragangliomas are uncommon tumors arising from the neuroendocrine elements (chief cells) of the paraganglia and symmetrically distributed along the aorta in close association with the sympathetic chain. Although functional tumors are easier to diagnose due to the clinical fi ndings caused by excess secretion of catecholamines and an elevation of the urinary catecholamine levels, however the diagnosis of nonfunctioning paraganglioma of the retroperitoneum is diffi cult and only few cases have been made before exploratory laparotomy. Although our patient was initially planned and operated by our gynaecological team, the incidental fi ndings had to involve the general surgeons. She is fortunate that the tumour did not show any features of malignancy nor metastasis, however a long time follow up is needed in case of any possible recurrence. KEYWORDS: Paraganglioma, Non-functioning, Retroperitonium","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45593833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Azrina, M. Basri, M. A. Hadi, M. Fahmi, O. Ariff, MY Asmarawati
High frequency oscillating ventilation (HFOV) provides a rescue therapy for patients with refractory hypoxaemia in severe acute respiratory distress syndrome (ARDS). HFOV utilizes high mean airway pressures to maintain an open lung and low tidal volumes at a high frequency that allows for adequate ventilation while at the same time preventing alveolar overdistension. This seems to be an ideal lung protective ventilation strategies to prevent ventilator-induced lung injury (VILI)2. We reported a case of severe extrapulmonary ARDS secondary to acute lymphoblastic leukaemia responding to the use of HFOV.
{"title":"High Frequency Oscillating Ventilation (HFOV) in Severe Acute Respiratory Distress Syndrome (ARDS): A Case Report.","authors":"Azrina, M. Basri, M. A. Hadi, M. Fahmi, O. Ariff, MY Asmarawati","doi":"10.31436/IMJM.V9I1.742","DOIUrl":"https://doi.org/10.31436/IMJM.V9I1.742","url":null,"abstract":"High frequency oscillating ventilation (HFOV) provides a rescue therapy for patients with refractory hypoxaemia in severe acute respiratory distress syndrome (ARDS). HFOV utilizes high mean airway pressures to maintain an open lung and low tidal volumes at a high frequency that allows for adequate ventilation while at the same time preventing alveolar overdistension. This seems to be an ideal lung protective ventilation strategies to prevent ventilator-induced lung injury (VILI)2. We reported a case of severe extrapulmonary ARDS secondary to acute lymphoblastic leukaemia responding to the use of HFOV.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42226585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ABSTRACT Rheumatoid arthritis (RA) is a systemic disease affecting mainly joints. Since rheumatoid arthritis is a common and a world wide problem therefore accurate diagnosis of this disease is essential. In the past rheumatoid factor was considered as the only marker for diagnosing this disease; however rheumatoid factor is present in many other disorders and even in up to 15% of healthy population. For the detection of rheumatoid arthritis, over the years many auto antibodies have been reported such as anti perinuclear factor (APF) and anti keratin antibodies (AKA) but they were not specifi c and due to the tedious procedure used for their laboratory diagnosis, they could not become popular for the diagnosis of this disease. Recently anti-CCP antibodies have been reported and they are becoming popular due to their high sensitivity and specifi city. It is hoped that in a couple of years time anti-CCP antibodies could be included in the ACR criteria for diagnosing RA. KEYWORDS: Rheumatoid factor, anti perinuclear factor, anti keratin antibodies, anti-cyclic citrullinated peptide antibodies
{"title":"Anti-CCP Antibodies: an Emerging Marker for the Early Diagnosis of Rheumatoid Arthritis","authors":"K. Sarah, A. Nadeem","doi":"10.31436/IMJM.V9I1.745","DOIUrl":"https://doi.org/10.31436/IMJM.V9I1.745","url":null,"abstract":"ABSTRACT Rheumatoid arthritis (RA) is a systemic disease affecting mainly joints. Since rheumatoid arthritis is a common and a world wide problem therefore accurate diagnosis of this disease is essential. In the past rheumatoid factor was considered as the only marker for diagnosing this disease; however rheumatoid factor is present in many other disorders and even in up to 15% of healthy population. For the detection of rheumatoid arthritis, over the years many auto antibodies have been reported such as anti perinuclear factor (APF) and anti keratin antibodies (AKA) but they were not specifi c and due to the tedious procedure used for their laboratory diagnosis, they could not become popular for the diagnosis of this disease. Recently anti-CCP antibodies have been reported and they are becoming popular due to their high sensitivity and specifi city. It is hoped that in a couple of years time anti-CCP antibodies could be included in the ACR criteria for diagnosing RA. KEYWORDS: Rheumatoid factor, anti perinuclear factor, anti keratin antibodies, anti-cyclic citrullinated peptide antibodies","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48835537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain is infl uenced by multiple factors including personal experience, psychological, sociocultural and situational factors. Failure to recognise pain will lead to poor patient management and deleterious effect on the patients’ wellbeing. Assessing pain in paediatric and cognitively compromised patients remains a challenge. Pain assessment in these groups of patients depends on the observers’ assessment and studies have shown the discrepancy between the observers’ assessment and patients’ verbal report. A specifi c and accurate tool is required to assist in the pain assessment. Although there are assessment tools available using behaviour scoring system and physiological indicators, none of the tool demonstrates its superiority than the others. Biochemical indicators such as stress hormones are frequently measured and used in con-junction with verbal reports; however they are non specifi c to pain and are increased in infl ammation, haemodynamic and emotional changes. The association between immunological indicators e.g. IL-1 , IL-6, IL8 and clinical pain has been shown, however; the defi nite correlation of the changes in the indicators and the level of pain is still unclear and may require further investigation.
{"title":"Non-Verbal Pain Assessment: A Literature Review","authors":"Aa Che Badariah, H. S. Kamalrujan","doi":"10.31436/IMJM.V9I1.746","DOIUrl":"https://doi.org/10.31436/IMJM.V9I1.746","url":null,"abstract":"Pain is infl uenced by multiple factors including personal experience, psychological, sociocultural and situational factors. Failure to recognise pain will lead to poor patient management and deleterious effect on the patients’ wellbeing. Assessing pain in paediatric and cognitively compromised patients remains a challenge. Pain assessment in these groups of patients depends on the observers’ assessment and studies have shown the discrepancy between the observers’ assessment and patients’ verbal report. A specifi c and accurate tool is required to assist in the pain assessment. Although there are assessment tools available using behaviour scoring system and physiological indicators, none of the tool demonstrates its superiority than the others. Biochemical indicators such as stress hormones are frequently measured and used in con-junction with verbal reports; however they are non specifi c to pain and are increased in infl ammation, haemodynamic and emotional changes. The association between immunological indicators e.g. IL-1 , IL-6, IL8 and clinical pain has been shown, however; the defi nite correlation of the changes in the indicators and the level of pain is still unclear and may require further investigation.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42106401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The study was done at the aim to assess the functionality and viability of the β cells of the streptozotocin-induced diabetic rats model following repetitive dosage of administration of ethanolic extracts of Andrographis paniculata. Materials and Methods: The diabetic rats were treated with the extracts for fourteen days and at the dose given was 500 mg/kg twice daily. The assessments were made on fasting blood glucose, insulin, and immunohistochemical aspect of β cells before and after treatment. Results: The results showed that there was a signifi cant reduction on fasting blood glucose levels in metformin, 95% and 50% ethanolic plant extracts-treated groups but on insulin level only 95% and 50% ethanolic extracts-treated groups gave a signifi cant reduction (p<0.05). Immunohistochemical assessments revealed that all extract groups and metformin-treated were signifi cantly increased in the population of β cells (p<0.01). Conclusion: This study revealed that the plant extracts showed an ability to promote the growth or rejuvenate the STZdestructed β cells and in turn lower the blood glucose level.
{"title":"Assessment on Functionality and Viability of β cells Following Repetitive Dosage Administration of Ethanolic Extracts of Andrographis paniculata on Streptozotocin-induced Diabetic Rats.","authors":"A. Kasmuri, Maria Ahmad, A. Sadikun, M. Asmawi","doi":"10.31436/IMJM.V9I1.737","DOIUrl":"https://doi.org/10.31436/IMJM.V9I1.737","url":null,"abstract":"Introduction: The study was done at the aim to assess the functionality and viability of the β cells of the streptozotocin-induced diabetic rats model following repetitive dosage of administration of ethanolic extracts of Andrographis paniculata. Materials and Methods: The diabetic rats were treated with the extracts for fourteen days and at the dose given was 500 mg/kg twice daily. The assessments were made on fasting blood glucose, insulin, and immunohistochemical aspect of β cells before and after treatment. \u0000Results: The results showed that there was a signifi cant reduction on fasting blood glucose levels in metformin, 95% and 50% ethanolic plant extracts-treated groups but on insulin level only 95% and 50% ethanolic extracts-treated \u0000groups gave a signifi cant reduction (p<0.05). Immunohistochemical assessments revealed that all extract \u0000groups and metformin-treated were signifi cantly increased in the population of β cells (p<0.01). \u0000Conclusion: This study revealed that the plant extracts showed an ability to promote the growth or rejuvenate the STZdestructed β cells and in turn lower the blood glucose level.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43209137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ABSTRACT Introduction: Diabetes Mellitus (DM) is a chronic metabolite disorder with high potential of multisystemic medical complications especially among poorly controlled patients. This study was conducted at Raja Perempuan Zainab II Hospital, Kota Bharu with objectives to explore the pattern of common diabetic mellitus type 2 complications and to compare between gender and races in relation to other risk factors during their hospitalization. Materials and Methods: This is a retrospective study based on patients’ record involving 215 patients (110 women and 105 men) who were admitted with diabetic complications in medical ward for a period of 6 months (January to June 2006) Results: Out of total 300 identifi ed subjects, 285 case notes were traceable. From 285, 84.6% (241 subjects) were diagnosed as DM type 2. 215 out of 241 subjects (89.2%) had one or more diabetic complications. In general the most common diabetic complication was diabetic nephropathy 34.9% (75 patients). When we compared between genders, diabetic foot ulcers was the most common diabetic complications among males (43.8%) and diabetic nephropathy for females (40.9%). A total of 199 patients (92.6%) had poor blood sugar control during their hospitalization and 103 patients (47.9%) had hypertension. Conclusion: Patients with DM type 2 had a high prevalence of complications. Common diabetic complications among genders were varied. Patients with diabetic complications had high prevalence of risk factors such as poor blood sugar control, concomitant hypertension and smoking habit. KEYWORDS: Diabetes mellitus type 2, complications, risk factors.
摘要简介：糖尿病（DM）是一种慢性代谢紊乱，有很高的多系统并发症的可能性，尤其是在控制不佳的患者中。这项研究在Kota Bharu的Raja Perempuan Zainab II医院进行，目的是探索常见的2型糖尿病并发症的模式，并比较住院期间性别和种族与其他风险因素的关系。材料和方法：这是一项基于患者记录的回顾性研究，涉及215名患者（110名女性和105名男性），这些患者因糖尿病并发症在医疗病房住院6个月（2006年1月至6月）。285例患者中，84.6%（241名受试者）被诊断为2型糖尿病。241名受试者中有215人（89.2%）有一种或多种糖尿病并发症。一般来说，最常见的糖尿病并发症是糖尿病肾病34.9%（75例）。当我们对性别进行比较时，糖尿病足溃疡是男性最常见的糖尿病并发症（43.8%），糖尿病肾病是女性最常见的并发症（40.9%）。共有199名患者（92.6%）在住院期间血糖控制不佳，103名患者（47.9%）患有高血压。结论：2型糖尿病患者并发症发生率较高。性别间常见的糖尿病并发症各不相同。糖尿病并发症患者的危险因素患病率较高，如血糖控制不佳、伴有高血压和吸烟习惯。关键词：2型糖尿病，并发症，危险因素。
{"title":"Medical complications among type 2 diabetes mellitus patients at a general hospital in East Coast Malaysia","authors":"M. NoorHasimah, Nurhanani Mn, M. Ramli","doi":"10.31436/IMJM.V9I1.736","DOIUrl":"https://doi.org/10.31436/IMJM.V9I1.736","url":null,"abstract":"ABSTRACT Introduction: Diabetes Mellitus (DM) is a chronic metabolite disorder with high potential of multisystemic medical complications especially among poorly controlled patients. This study was conducted at Raja Perempuan Zainab II Hospital, Kota Bharu with objectives to explore the pattern of common diabetic mellitus type 2 complications and to compare between gender and races in relation to other risk factors during their hospitalization. Materials and Methods: This is a retrospective study based on patients’ record involving 215 patients (110 women and 105 men) who were admitted with diabetic complications in medical ward for a period of 6 months (January to June 2006) Results: Out of total 300 identifi ed subjects, 285 case notes were traceable. From 285, 84.6% (241 subjects) were diagnosed as DM type 2. 215 out of 241 subjects (89.2%) had one or more diabetic complications. In general the most common diabetic complication was diabetic nephropathy 34.9% (75 patients). When we compared between genders, diabetic foot ulcers was the most common diabetic complications among males (43.8%) and diabetic nephropathy for females (40.9%). A total of 199 patients (92.6%) had poor blood sugar control during their hospitalization and 103 patients (47.9%) had hypertension. Conclusion: Patients with DM type 2 had a high prevalence of complications. Common diabetic complications among genders were varied. Patients with diabetic complications had high prevalence of risk factors such as poor blood sugar control, concomitant hypertension and smoking habit. KEYWORDS: Diabetes mellitus type 2, complications, risk factors.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48064544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Various initiatives and medications have been introduced to achieve better control of bronchial asthma. However total control according to Global Initiative for Asthma (GINA) remains elusive even at tertiary referral hospitals. Our study is to determine the level of asthma control (according to GINA 2009), Asthma Control Test (ACT) scores and the types of medications used among patients with bronchial asthma in a large tertiary hospital. Methods: A cross-sectional study of all patients with bronchial asthma who attended the Chest Clinic at Hospital Tengku Ampuan Afzan (HTAA) from 2009 to 2011. Patient demographics, self-administered ACT scores, GINA-defined level of asthma control and medications were documented. Results: 208 patients were recruited. There were 23.2%, 46.3% and 30.5% of patients with controlled, partly controlled and uncontrolled asthma respectively. The median ACT scores was 19 [inter quartile range (IQR) 6]. The most frequently used preventer therapy was inhaled long-acting β-agonist/corticosteroids (LABA/ICS) fixed-dose combination (61.7%), and 9.6% were not on preventer therapy. 75% of patients with controlled asthma were on LABA/ICS compared to 58.5% of the partly controlled and uncontrolled groups (p=0.039). Conclusion: The majority of the asthmatic patients attending the Chest Clinic at HTAA did not have GINA-defined controlled asthma. Patients with higher ACT scores had better control of asthma. There were more patients with controlled asthma who were on LABA/ ICS combination.
{"title":"Asthma control in Hospital Tengku Ampuan Afzan, Kuantan, Malaysia: a cross-sectional study","authors":"Y. Kuan, C. H. Tan, C. M. Hong, S. How","doi":"10.31436/IMJM.V14I2.433","DOIUrl":"https://doi.org/10.31436/IMJM.V14I2.433","url":null,"abstract":"Introduction: Various initiatives and medications have been introduced to achieve better control of bronchial asthma. However total control according to Global Initiative for Asthma (GINA) remains elusive even at tertiary referral hospitals. Our study is to determine the level of asthma control (according to GINA 2009), Asthma Control Test (ACT) scores and the types of medications used among patients with bronchial asthma in a large tertiary hospital. Methods: A cross-sectional study of all patients with bronchial asthma who attended the Chest Clinic at Hospital Tengku Ampuan Afzan (HTAA) from 2009 to 2011. Patient demographics, self-administered ACT scores, GINA-defined level of asthma control and medications were documented. Results: 208 patients were recruited. There were 23.2%, 46.3% and 30.5% of patients with controlled, partly controlled and uncontrolled asthma respectively. The median ACT scores was 19 [inter quartile range (IQR) 6]. The most frequently used preventer therapy was inhaled long-acting β-agonist/corticosteroids (LABA/ICS) fixed-dose combination (61.7%), and 9.6% were not on preventer therapy. 75% of patients with controlled asthma were on LABA/ICS compared to 58.5% of the partly controlled and uncontrolled groups (p=0.039). Conclusion: The majority of the asthmatic patients attending the Chest Clinic at HTAA did not have GINA-defined controlled asthma. Patients with higher ACT scores had better control of asthma. There were more patients with controlled asthma who were on LABA/ ICS combination.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45374916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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