exudates and Edema

Opioid dependence remains the main type of illicit substance used in Malaysia, which has an estimated 187 771 opiate users. There are currently 333 active methadone maintenance treatment centres nationwide. Although methadone has proven to be an effective maintenance therapy, it has clinical concerns which can have an impact on its effectiveness and safety.. A case series of seven patients from Malaysian private and public hospital settings who had an adverse reaction with methadone is discussed.. Despite methadone being an effective therapy for opioid dependence, there is a need for other alternative effective therapies, such as naltrexone, buprenorphine and the co-formulation of buprenorphine-naloxone, to be made available to physicians in both public and private sectors. There is need for individual treatment consideration to avoid adverse effects, drug-drug interactions, overdosing and in the presence of co-morbidities. An emphasis on safe storage of takeaway methadone is also needed. [George P, Vicknasingam B, Thurairajasingam S, Ramasamy P, Mohd Yusof H, Yasin MABM, Shah ZUBS. Methadone complications amongst opioid-dependent patients in Malaysia: A case series. Drug Alcohol Rev 2018;37:147-151].

Topics: Adult; Child, Preschool; Drug Overdose; Edema; Female; Humans; Malaysia; Male; Methadone; Narcotics; Opiate Substitution Treatment; Opioid-Related Disorders; Pruritus

Vena cava compression is a relatively rare initial manifestation of underlying malignancy. The superior vena cava syndrome, which is characterized by facial plethora, jugular venous distension, and arm swelling, is a well-known entity associated with bronchogenic carcinoma. Less common is the compression of the inferior vena cava. To the best of my knowledge, this is the first reported case of newly diagnosed gastric adenocarcinoma presenting initially as the inferior vena cava syndrome. The unique aspect about this case is that it highlights a rare presentation before diagnosis of gastric adenocarcinoma.. A 56-year-old Malaysian woman with a past medical history of iron deficiency anemia presented with lower extremity edema and progressive fatigue of 1 month's duration. She had significant worsening of leg swelling after standing for short periods of time. She also reported epigastric discomfort, which led to an additional workup, including computed tomography of the abdomen and pelvis. This revealed a 3cm×2.9cm mass in the stomach, extensive hepatic metastasis, and severe inferior vena cava compression. The patient was examined further with esophagogastroduodenoscopy, and a biopsy showed gastric adenocarcinoma.. This report describes a case of a patient with inferior vena cava syndrome as a unique presentation of previously undiagnosed stage IV gastric adenocarcinoma. Patients presenting with inferior vena cava syndrome should undergo prompt evaluation for underlying malignancies that have a predilection for hepatic metastasis. This case is important because earlier recognition of this syndrome can lead to earlier workup and thus detection of malignancy. Prompt initiation of treatment, including chemotherapy or vena cava stent placement, can result in improved patient outcome.

Topics: Adenocarcinoma; Anemia, Iron-Deficiency; Antineoplastic Combined Chemotherapy Protocols; Budd-Chiari Syndrome; Disease Progression; Edema; Endoscopy, Gastrointestinal; Fatigue; Female; Humans; Lower Extremity; Malaysia; Middle Aged; Neoplasm Staging; Paclitaxel; Stomach Neoplasms; Syndrome; Tomography, X-Ray Computed; Trastuzumab; Treatment Outcome; Vena Cava, Inferior

The present study was carried out to investigate the antinociceptive and anti-inflammatory activities of virgin coconut oil (VCO) produced by the Malaysian Agriculture Research and Development Institute (MARDI) using various in vivo models.. Two types of VCOs, produced via standard drying (VCOA) and fermentation (VCOB) processes were used in this study. Both VCOA and VCOB were serially diluted using 1% Tween 80 to concentrations (v/v) of 10, 50 and 100%. Antinociceptive and anti- inflammatory activities of both VCOs were examined using various in vivo model systems. The antinociceptive activity of the VCOs were compared to those of 1% Tween 80 (used as a negative control), morphine (5 mg/kg) and/or acetylsalicylic acid (100 mg/kg).. Both VCOA and VCOB exhibited significant (p < 0.05) dose-dependent antinociceptive activity in the acetic acid-induced writhing test. Both VCOs also exerted significant (p < 0.05) antinociceptive activity in both phases of the formalin and hot-plate tests. Interestingly, the VCOs exhibited anti-inflammatory activity in an acute (carrageenan-induced paw edema test), but not in a chronic (cotton-pellet-induced granuloma test) model of inflammation.. The MARDI-produced VCOs possessed antinociceptive and anti-inflammatory activities. Further studies are needed to confirm these observations.

Topics: Abdomen; Analgesics; Animals; Anti-Inflammatory Agents; Coconut Oil; Disease Models, Animal; Edema; Granuloma; Malaysia; Male; Mice; Mice, Inbred BALB C; Muscle Contraction; Pain; Pain Measurement; Phytotherapy; Plant Oils; Rats; Rats, Sprague-Dawley

Domestic maid violence is an assault and coercive behaviour, which mainly includes physical, psychological and at times sexual too, by employer or household members of employer against a person hired as a domestic help. Maid abuse is well known but poorly documented in scientific literature. This is an important global issue. In this article, two illustrated cases of maid abuse are discussed. Their employers allegedly subjected both the victims to physical and psychological trauma. The physical examination of the victims showed poor state of clothing, nutrition, and presence of injuries of different duration. The bruises were irregular to patterned, and were inflicted by beating. Both cases had eczematous contact dermatitis over palms and soles, paronechia, and sub-ungal fungal infection due to unprotected working in wet conditions. In both cases, external ears were deformed like cauliflowers due to repeated trauma. All cases had multiple injuries of varying duration. In this paper, medico-legal and social issues related to maid abuse are also discussed in detail. A possible solution to minimise maid abuse is also suggested. This paper highlights and document maid abuse.

Topics: Adult; Anemia; Contracture; Dermatitis, Contact; Dermatomycoses; Domestic Violence; Ear, External; Edema; Female; Finger Joint; Forensic Medicine; Household Work; Humans; Hypoproteinemia; Malaysia; Malnutrition; Nail Diseases; Physical Exertion; Wounds and Injuries

Twenty-seven inmates from a detention centre in Perak were evaluated for possible causes of their ankle oedema. Physical examination and biochemical evaluation did not show any evidence of renal or hepatic dysfunction. The cardiac origin of their problem was suggested by the presence of other signs of heart failure in three of them and by radiological evidence of cardiomegaly in 40% of them. All the patients who returned for review demonstrated a prompt clinical response to thiamine replacement therapy.

Topics: Adult; Ankle; Bangladesh; Cardiomegaly; Edema; Emigration and Immigration; Humans; Malaysia; Prisoners; Thiamine; Thiamine Deficiency

The white blood cell DNA of 36 cord blood samples with Hb Bart's in the red blood cells was studied for alpha-globin gene deletions by hybridization of DNA fragments digested by the restriction endonucleases Eco RI, Hpa I, Bam HI, and Bgl II. All 16 DNA samples from cord blood with Hb Bart's below 3% and no other abnormal hemoglobin had one alpha-globin gene deletion (alpha thal2), except one which had two alpha-globin gene deletions (alpha thal1). Most of the alpha thal2 were of the rightward deletion alpha thal2 genotype. Two new types of alpha thal2 variation was found, probably due to a polymorphism somewhere in an area outside the alpha-globin gene. All 14 cases with Hb Bart's between 3.5% and 8.5% and no other abnormal hemoglobin had two alpha-globin gene deletions (alpha thal1), except one that did not have any alpha-globin gene deletion and one that had one alpha-globin gene deletion. Three DNA samples of cord blood with Hb Bart's accompanied by Hb CoSp did not have any alpha-globin gene deletion. Sixty-five DNA samples from cord blood without Hb Bart's or other abnormal hemoglobin had no alpha-globin gene deletions, except one that had one alpha-globin gene deletion (alpha thal2). Two of the 65 DNA samples were found to have triplicated alpha-globin gene loci.

Topics: DNA; Edema; Erythroblastosis, Fetal; Female; Fetal Blood; Genes; Globins; Hemoglobins, Abnormal; Humans; Infant, Newborn; Malaysia; Nucleic Acid Hybridization; Pregnancy; Racial Groups; Thalassemia

Topics: Adolescent; Adult; Age Factors; Bronchitis; Child; Child, Preschool; Cough; Ductus Arteriosus, Patent; Dyspnea; Edema; Ethnicity; Female; Fever; Humans; Infant Nutrition Disorders; Malaysia; Male; Middle Aged; Radiography; Sex Factors

Topics: Adult; Africa; Asia; Australia; Body Height; Body Weight; Deficiency Diseases; Diet Therapy; Eclampsia; Edema; Epidemiologic Methods; Europe; Female; Humans; Hypertension; Israel; Jamaica; Kidney Diseases; Malaysia; Maternal Age; Maternal Mortality; New Zealand; Pre-Eclampsia; Pregnancy; Proteinuria; Racial Groups; Social Class; Socioeconomic Factors; South America; Trinidad and Tobago; United States; USSR; Warfare

Topics: Adolescent; Adult; Asian People; Birth Weight; Black or African American; Black People; Blood Pressure; Body Height; Body Weight; Edema; Female; Hong Kong; Humans; Infant, Newborn; Labor, Obstetric; Malaysia; Maternal Age; Nigeria; Pre-Eclampsia; Pregnancy; Proteinuria; Retrospective Studies; Scotland; Social Conditions; Tropical Climate; White People

Topics: alpha-Thalassemia; beta-Thalassemia; Edema; Erythroblastosis, Fetal; Erythroblasts; Hemoglobins; Hemoglobins, Abnormal; Humans; Hydrops Fetalis; Infant, Newborn; Malaysia; Thalassemia