274 results match your criteria: "Hospital Pulau Pinang[Affiliation]"

Background Calcific uremic arteriolopathy (CUA) is a rare but debilitating disease affecting patients with kidney disease. Reported risk factors of CUA in the literature include female sex, obesity, diabetes mellitus, and vitamin K antagonists' (VKAs) usage. CUA prevalence in Malaysia is unknown and has not been reported before.

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Thrombotic microangiopathy (TMA) is a serious complication that may affect post-renal transplant recipients. De novo TMA has been linked to the use of transplant immunosuppressive agents, including calcineurin inhibitors (CNI) and mammalian target of rapamycin inhibitors (mTORi). We report a case of a 41-year-old female renal transplant recipient who presented with hemolytic anemia, thrombocytopenia, and acute allograft dysfunction.

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Introduction: The MERIT study in Malaysia is a real-world retrospective, observational, multicenter study that evaluated asthma control in patients with uncontrolled asthma who were switched from as-needed (pro re nata [PRN]) budesonide/formoterol or inhaled corticosteroid (ICS) whenever a short-acting beta-agonist (SABA) was taken, to proactive regular dosing of fluticasone propionate/salmeterol (FP/SAL PRD).

Methods: Data from the medical records of patients who were stepped up to FP/SAL PRD were extracted retrospectively at baseline and follow-up (between 3 and 6 months after stepping up to FP/SAL PRD). The primary endpoint was the percentage of patients with improvement in asthma control assessed via the Asthma Control Test (ACT).

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Current feedback models advocate learner autonomy in seeking, processing, and responding to feedback so that medical students can become feedback-literate. Feedback literacy improves learners' motivation, engagement, and satisfaction, which in turn enhance their competencies. However, there is a lack of an objective method of measuring medical student feedback literacy in the empirical literature.

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Background: Dry powder inhalers (DPIs) are commonly used among patients with Chronic Obstructive Pulmonary Disease (COPD). These inhalers are breath-actuated, and require patients to generate sufficient peak inspiratory flow (PIF) to disaggregate the drug powder into respirable fine particles and deliver it to the lower airway tracts. Inhaler personalisation based on PIF among DPI users has not been studied in Malaysia, thus we conducted the present pilot study to determine the feasibility of conducting such research among COPD patients.

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Clinical, biochemical, molecular characteristics and clinical outcome of hyperhomocysteinemia in Malaysian children.

Clin Biochem

December 2024

Molecular Diagnostics Unit, Biochemistry & Genomics Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Kuala Lumpur, Malaysia.

Background: Hyperhomocysteinemia can be due to various abnormalities of the complex interaction of methionine, folate and vitamin B12. It has been known to be a cardiovascular risk factor. This study aims to review the clinical presentation, underlying causes and clinical outcome in paediatric patients diagnosed with significant hyperhomocysteinemia in Malaysia.

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Poncet disease in a patient with smear-negative pulmonary tuberculosis: A case report.

Malays Fam Physician

August 2024

MD, MPath (Anatomic Pathology), Hospital Pulau Pinang, Jalan Residensi, George Town, Ministry of Health Malaysia, Penang, Malaysia.

Article Synopsis
  • Pulmonary tuberculosis can be hard to diagnose when patients don’t show typical symptoms, leading to confusion for doctors.
  • Poncet disease is a condition related to tuberculosis that causes joint pain and skin lesions without destructive infection.
  • A case study showed a patient with joint pain and skin nodules who was ultimately diagnosed with smear-negative pulmonary tuberculosis, and their symptoms improved after starting treatment.
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Mortality, perioperative complications and surgical timelines in hip fracture patients: Comparison of the Spanish with the non-Spanish Cohort of the HIP ATTACK-1 trial.

Injury

November 2024

Population Health Research Institute, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Background: Hip fractures carry a substantial risk of complications and death. This study aimed to report the 90-day incidence of mortality, major perioperative complications and in-hospital timelines after a hip fracture in the Spanish HIP ATTACK-1 trial cohort, comparing with the non-Spanish cohort.

Methods: Prospective cohort study of Spanish patients nested in the HIP ATTACK-1 trial.

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Introduction: Blood culture contamination remains a dilemma issue in the diagnosis of bloodstream infection. However, to date, there is no national data on blood culture contamination and the common organism isolated in Malaysia. This is a pioneer multi-centre study involving public hospitals with medical microbiologists in Malaysia to determine the blood culture contamination rate and the common organism isolated.

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Article Synopsis
  • Alzheimer's disease (AD) poses significant challenges for health policy in Malaysia, particularly regarding the costs associated with treating older adults.
  • A study was conducted in six Malaysian hospitals to evaluate the direct healthcare expenditures for AD patients aged 65 and above from 2016 to 2021, utilizing a bottom-up micro-costing approach.
  • The findings revealed an average annual direct healthcare cost of RM2641.30 (USD 572.45) per patient, with costs increasing alongside disease severity and notably higher expenses for patients aged 81 and above, emphasizing the need for effective healthcare policies for geriatric care.
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Introduction Spine fracture in association with traumatic dural tear is a serious injury. A traumatic dural tear is difficult to determine based on initial clinical presentation and radiological imaging even with magnetic resonance imaging (MRI). However, during decompression surgery, cerebrospinal fluid leaks surrounding the injured segments are usually confirmed by directly visualizing them.

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Objective: To understand the etiological landscape and phenotypic differences between 2 developmental and epileptic encephalopathy (DEE) syndromes: DEE with spike-wave activation in sleep (DEE-SWAS) and epileptic encephalopathy with spike-wave activation in sleep (EE-SWAS).

Methods: All patients fulfilled International League Against Epilepsy (ILAE) DEE-SWAS or EE-SWAS criteria with a Core cohort (n = 91) drawn from our Epilepsy Genetics research program, together with 10 etiologically solved patients referred by collaborators in the Expanded cohort (n = 101). Detailed phenotyping and analysis of molecular genetic results were performed.

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Delayed sputum conversion has been associated with a higher risk of treatment failure or relapse among drug susceptible smear-positive pulmonary tuberculosis patients. Several contributing factors have been identified in many studies, but the results varied across regions and countries. Therefore, the current study aimed to develop a predictive model that explained the factors affecting time to sputum conversion within two months after initiating antituberculosis agents among Malaysian with drug-susceptible smear-positive pulmonary tuberculosis patients.

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Introduction: Sexual health education among individuals with autism spectrum disorder (ASD) is unique and may not be adequately addressed both at home and at school. Parents have an important role in delivering sexual health education to their children. This is a pilot study to evaluate parental awareness and effectiveness of parent sexual health training for children with ASD.

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Article Synopsis
  • - Acute subdural hematomas (ASDHs) pose significant risks, particularly for elderly patients, with traditional surgeries having limited success even post-operation.
  • - A study analyzed the outcomes of six elderly patients who underwent endoscopic surgery for ASDH, finding that 66.7% showed good recovery and no complications occurred.
  • - The research suggests that endoscopic ASDH evacuation (EASE) is as effective as traditional craniotomy, especially when considering factors like the contralateral global cortical atrophy (GCA) score rather than just age.
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A hierarchical cluster analysis for clinical profiling of tofacitinib treatment response in patients with rheumatoid arthritis.

Clin Rheumatol

August 2024

Centre for Cancer and Stem Cell Research Development and Innovation (IRDI), Institute for Research, IMU University, Kuala Lumpur, Malaysia.

Tofacitinib is the first oral JAK inhibitor approved for treating rheumatoid arthritis (RA). To enhance our understanding of tofacitinib drug response, we used hierarchical clustering to analyse the profiles of patient who responded to the treatment in a real-world setting. Patients who commenced on tofacitinib treatment were selected from 12 major rheumatology centres in Malaysia.

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Objective: Inappropriate use of short-acting beta2-agonists (SABA) in asthma has been associated with undesired outcomes. This national expert consensus was developed to increase awareness of SABA overuse and provide recommendations on the ways to eliminate SABA overprescription and overreliance in Malaysia.

Data Sources: This expert consensus was developed by searching the PubMed database, using index terms to identify SABA overuse-related burden and recommendations made in asthma guidelines.

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A retrospective review of antiphospholipid syndrome: a single tertiary centre experience.

Med J Malaysia

May 2024

Hospital Pulau Pinang, Medical Department, Rheumatology Unit, Penang, Malaysia.

Article Synopsis
  • Antiphospholipid syndrome (APS) is an autoimmune disease causing thrombosis and pregnancy issues linked to antiphospholipid antibodies, and the study aimed to explore its clinical features, treatments, and outcomes in patients over a year-long period.
  • The study analyzed 53 APS patients, revealing that thrombosis was the most common manifestation, with a significant proportion also experiencing pregnancy complications and various other related health issues.
  • The majority of patients were treated with warfarin, and findings suggested high rates of pregnancy morbidity and similar thrombosis incidents compared to other global populations.
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Spinal tuberculosis is an uncommon extrapulmonary manifestation of tuberculosis infection, known as a great masquerade that often mimics other pathologies, such as pyogenic and non-pyogenic infection, bone metastasis, haematological malignancy, and metabolic bone disease. It presents great challenges in establishing a diagnosis, deciding on treatment, and monitoring the response to treatment. A tissue-proven diagnosis is the cornerstone of a definitive diagnosis before initiating medical antitubercular therapy, leading to successful treatment.

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Clinical characteristic and management of haemophilia patients in Malaysia: A single centre experience.

Med J Malaysia

March 2024

Hospital Pulau Pinang, Department of Medicine, Haematology Unit, Pulau Pinang, Malaysia.

Introduction: Haemophilia is one of the commonest inherited bleeding disorders which may lead to long term disabilities if not treated properly. Our aim of study is to understand the clinical characteristic, treatment and complications of adult haemophilia patients in our centre.

Materials And Methods: A retrospective cross-sectional review of all adult haemophilia A (HA) or haemophilia B (HB) patients who received treatment in Hospital Pulau Pinang from January 2021 to December 2022 was conducted.

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Unlabelled: Fracture risk stratification is crucial in countries with limited access to bone density measurement. 24.8% women were in the high-risk category while 30.

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Background: The COVID-19 pandemic has caused major impacts in various aspects of our life. In Malaysia, a Movement Control Order was imposed in March 2020. For almost two years, school going children and adolescents were not able to attend school physically, and their physical activity was confined within their room or house on most days.

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Objectives Compared with the first stroke, neurological impairment caused by stroke recurrence is more serious, more difficult to treat, and has a higher mortality rate, especially among ischemic stroke (IS) patients with diabetes mellitus (DM). Although there are established correlations between factors and IS recurrence, there were some issues regarding the naive hazard of IS recurrence with no risk factor influence, and how does the baseline hazard differ among patients with DM and non-DM? To answer all these questions, two time-to-event (TTE) models of recurrent IS after the index IS were developed among IS patients with DM and non-DM. Method A total of 7697 patients with an index IS attack were extracted from the Malaysian Registry of Neurology and stratified according to DM status.

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