Medicine Malaysia

Ultrasound in Rheumatology

2009-07-04T17:54:00.001+08:00

Over the years, the role of subspecialties in internal medicine has expanded. Many procedures, which were previously under the purview of other specialties, have since been mandatory skills to be obtained during subspecialty training. In rheumatology, ultrasound is gaining acceptance as a vital tool in aiding diagnosis and monitoring of therapeutic responses to assisting invasive procedures, for

H1N1: A real life public health drill

2009-06-27T13:46:00.000+08:00

With the hype over this global pandemic intensifying, there appears to be an argument as to what this illness should be called. As the world waits intently for a vaccine to be developed, the only method of containment is isolation. With expected rise in the number of cases, it will surely become more costly and labour intensive to maintain a reasonable tab on the cases and their respective

1st Case of A(H1N1) in Malaysia

2009-05-15T16:29:00.001+08:00

First confirmed case detected in Malaysia. Student from US.

Sued for wrong diagnosis and treatment

2009-05-15T00:09:00.002+08:00

From malaysiakiniHousewife sues gov't for RM7.5mHumayun Kabir | 14 May, 09 3:25pmA 54-year-old housewife is suing the government a whopping RM7.5 million in damages for a wrong diagnosis on cancer, which lead to the unnecessary removal of her left breast. Silvarany Thangavellu of Batu Gajah would seek RM5 million in general damages, and RM2.5 million in exemplary damages and damages for pain,

H1N1 closes in on Malaysia

2009-05-12T15:50:00.001+08:00

With the first confirmed case in Thailand, the flu virus is edging closer to our shores. It appears inevitable with the current momentum of spread.

A(H1N1) Flu : Potential Pandemic

2009-04-26T21:04:00.002+08:00

A H1N1 variant of the influenza virus which started from Mexico, and now suspected of spreading to the United States, has potential for human to human transmission. Although the mortality is reportedly only 1-3%, dozens have died in Mexico.Our Health Minster has directed screenings and checks at our entry points especially those from Mexico. How or whether it has truly been enforced is left to be

Interosseous Access in Adults

2009-04-20T22:42:00.002+08:00

Recent problems with IV access in patients with dengue shock syndrome has brought to light interosseous(IO) access, even in adults. Unfortunately, unlike in pediatrics, the expertise of inserting IO lines among adult medical staff is lacking. IO access was first researched among military personnel especially during combat situations, where IV access may be difficult. It has also been advocated

Web citations

2009-01-30T22:40:00.003+08:00

In this era of the internet, web citations are becoming increasingly common. However, one of the main problems is the fact that the documents can disappear from a previously searched URL in a flash. So when someone checks a web reference on your thesis, the page is no longer searchable. Firstly, how do one write a web reference in a proper format. Perhaps this example is useful.Plunkett, John. "

Gout: Recent Issues

2008-11-19T17:10:00.005+08:00

Several issues were raised and discussed at the recent ARA 2008 meeting. 1. Issues about treating asymptomatic hyperuricemia. Debate remains as to whether we should be treating hyperuricemia to prevent gout. As of now, we do not treat patients who have asymptomatic hyperuricemia2. The panel discussion in Medscape did highlight the fact that the regular dose of 300mg daily may be a rather

Pulmonary vein isolation beats AV node ablation for drug-refractory AF in HF patients

2008-10-27T12:17:00.003+08:00

Pulmonary vein isolation beats AV node ablation for drug-refractory AF in HF patients23 October 2008MedWire News: Pulmonary vein isolation is superior to atrioventricular (AV) node ablation with biventricular pacing for the treatment of drug-refractory atrial fibrillation (AF) in patients with heart failure (HF), conclude researchers. continuing story..Unfortunately, one requires a surgical

End of the road for Rimonabant?

2008-10-26T16:22:00.002+08:00

From medscape,Drug Maker Agrees to Suspend Rimonabant Marketing in Europefrom Heartwire — a professional news service of WebMDShelley WoodOctober 23, 2008 (Zurich, Switzerland) — Rimonbant's rough ride may be nearly over: today, the European Medicines Agency (EMEA) announced that it has recommended suspension of the weight-loss drug, marketed as Acomplia in Europe [1]. According to an EMEA

HYVET: Hypertension in the very elderly trial

2008-10-25T18:42:00.002+08:00

HYVET showed that indapamide SR* ±perindopril treatment significantly reduced total mortality by 21% (P=0.019) and stroke mortality by 39% (P=0.046).Furthermore, in patients receiving indapamide SR there were also relative risk reductions of 30% in stroke (P=0.055), of 64% in heart failure (P<0.001) and 34% in all cardiovascular events (P<0.001).This means that one death would be avoided for

Doubts on the benefits of aspirin

2008-10-23T23:16:00.004+08:00

Aspirin Does Not Prevent Heart Attacks in High-Risk PatientsDUNDEE, United Kingdom -- October 17, 2008 -- Taking regular aspirin and antioxidant supplements does not prevent heart attacks in high-risk groups with diabetes and asymptomatic arterial disease, according to a study published today in the online issue of the BMJ.Although there is considerable evidence showing no protective benefit of

Autoantibody Test Cost-Effective in Arthritis Diagnosis??

2008-10-21T11:00:00.006+08:00

Autoantibody Test Cost-Effective in Arthritis DiagnosisNEW YORK (Reuters Health) Oct 17 - Testing for autoantibodies against cyclic citrullinated peptide (aCCP) appears to be an economically feasible approach to early diagnosis of rheumatoid arthritis, and may even allow cost savings, German researchers report . more..Anti CCP can diagnose rheumatoid arthritis even before clinical symptoms become

Macrovascular benefits from long-term UKPDS

2008-10-20T16:01:00.002+08:00

Long term studies from the UKPDS now show macrovascular benefits on top of previously proven microvascular protection. The morale of the study is to treat early as aggressively as possible without much untoward hypoglycemic symptoms.

Microbial flora on restaurant beverage lemon slices.

2008-10-17T23:17:00.002+08:00

The next time you order a drink, you may get more than you bargained for. ConclusionAlthough lemons have known antimicrobial properties, the results of our study indicate that a wide variety of microorganisms may survive on the flesh and the rind of a sliced lemon. Restaurant patrons should be aware that lemon slices added to beverages may include potentially pathogenic microbes. Further

Warfarin Warning: Shortfalls in Anticoagulation for AF Up Risks of ICH and Embolic Stroke

2008-10-15T22:15:00.002+08:00

If the Americans are having problems maintaining INR targets with warfarin, I shudder to think what our data would be. (thesis project anyone??) Only 19% were in therapeutic range all the time according to this american study.Walker AM, Bennett D. Epidemiology and outcomes in patients with atrial fibrillation in the United States. Heart Rhythm. 2008;5:1365-1372. doi:10.1016/j.hrthm.2008.07.014.

Litigation : A trend?

2008-10-14T00:31:00.002+08:00

Housewife sues hospital, govt for RM5milBy EMBUN MAJIDALOR STAR: A housewife is suing the Government and the Sultan Abdul Halim Hospital for more than RM5mil in damages for alleged negligence that resulted in her suffering chronic kidney failure.K. Hemalatha, 31, from Taman Sutera, Sungai Petani filed a suit at the Alor Star High Court Registrar Office on Monday.In the suit, Hemalatha has named

Adalimumab Effective in Patients With Total Spinal Ankylosis

2008-10-09T00:28:00.002+08:00

Those of us who treats ankylosing spondylitis will realise how difficult it is to treat this inevitably progressive disease. This study suggests improvement in patients with spinal ankylosis given an anti TNF alpha, adalimumab. One major obstacle in Malaysia remains the cost. Many would argue that ultimately the disease is not cured but only offers symptomatic relief. Would one spend your life

Medical Rituals

2008-10-07T16:08:00.002+08:00

Malaysia, once again, famous for all the wrong reasons. However, it is an important part of humanity and has been in existence in all shapes and forms for centuries. There are no rules here, anything goes. It is like creating games for children where the only limitation is one's imagination. So the question is, why do reasonably educated individuals fall for such a scam? Vulnerability and

Virtual Colonoscopy

2008-10-02T15:23:00.003+08:00

A video presentation giving an opinion of virtual colonoscopy. I don't think the Gastroenterologists will be out of a job anytime soon. :-)

Ministry of Health short on funds

2008-10-01T00:13:00.003+08:00

I find this report recently in a local daily as perplexing. Slashing the budget of healthcare pushing the Minister of Health into a begging mode is ridiculous. When a hospital does not have a proper and well equipped emergency room, there should be an urgent need to rectify the situation.Instead, there is a budget cut. Such development funds are vital to ensure that Malaysia stays at a

Selamat Hari Raya Aidilfitri

2008-10-01T00:08:00.001+08:00

Wishing all Selamat Hari Raya. Have a great enjoyable time.

Overtransfusion?

2008-09-27T17:31:00.002+08:00

Following a report in The Star about "Blood supply low in hospitals"One of the said culprits was the increase in dengue cases leading to the need for transfusion. This raises questions as to whether we are transfusing patients necessarily.Those of us who have treated dengue will know that on most occasions there is little need to transfuse. One of the main pathophysiology of dengue shock syndrome

ECASS 3: Thrombolysis Beneficial Up to 4.5 Hours After Acute Ischemic Stroke

2008-09-27T12:56:00.003+08:00

The increase in the time frame for treatment will enable more patients to be eligible for treatment. The previous time frame was only 3 hours.Unfortunately many centers in Malaysia is still not practising thrombolysis for stroke patients. When patients come in with a stroke, they are practically on their own. Only supportive measures are instituted. The use of thrombolysis is only limited to