exudates and Headache

Although headache is one of the most common neurologic conditions with a high disease burden, primary data on headache research from Southeast Asia (SEA) was hypothesized to be inadequate. This study aimed to evaluate research productivity among the different countries in SEA and to determine the association between specific bibliometric indices and socioeconomic factors.. A systematic search was conducted until June 10, 2020 in Scopus, PubMed, Embase, Cochrane Central Register of Controlled Trials, and Index Medicus for South-East Asia Region to include all primary headache studies on migraine, tension-type headache, and trigeminal autonomic cephalalgia, with at least one author affiliated with a SEA country. Bibliometric indices, such as the number of publications and PlumX metrics, were obtained and correlated with the country-specific socioeconomic factors.. We identified 153 articles. Most of the publications (n = 43, 28.1%) were epidemiologic studies and case reports/series (n = 25, 16.3%). Migraine was the most studied primary headache subtype. Malaysia, Singapore, and Thailand were the major contributors to primary headache research in SEA. Only the percent gross domestic product for research and development correlated significantly with research productivity.. Despite the high global burden of disease, research productivity on primary headache was low in SEA. The move towards a knowledge-based economy may drive research productivity in SEA.

Topics: Asia, Southeastern; Bibliometrics; Biomedical Research; Headache; Humans; Malaysia; Socioeconomic Factors; Thailand

Long COVID is new or ongoing symptoms at four weeks or more after the start of acute COVID-19. However, the prevalence and factors associated with long COVID are largely unknown in Malaysia. We aim to determine the proportion and factors associated with long COVID among COVID-19 patients in Port Dickson, Malaysia. The positive outcomes of our long COVID active detection initiative were also described.. This was a retrospective analysis of long COVID data collected by the Port Dickson District Health Office between 1 September 2021 to 31 October 2021. Monitoring long COVID symptoms was our quality improvement initiative to safeguard residents' health in the district. The study population was patients previously diagnosed with COVID-19 who resided in Port Dickson. The inclusion criteria were adults aged 18 years and above and were in the fifth week (day 29 to 35) post-COVID-19 diagnosis during the data collection period. We called all consecutive eligible patients to inquire regarding long COVID symptoms. Long COVID was defined as new or ongoing symptoms lasting more than 28 days from the date of positive SARS-CoV-2 by polymerase chain reaction test. Binary multivariate logistic regression was conducted to determine factors associated with long COVID.. Among 452 patients, they were predominantly male (54.2%), Malays (68.8%) and aged 18-29 years (58.6%). A total of 27.4% (95% CI [23.4-31.8]) of patients experienced long COVID symptoms and were referred to government clinics. The most frequent long COVID symptoms experienced were fatigue (54.0%), cough (20.2%), muscle pain (18.5%), headache (17.7%) and sleep disturbance (16.1%). Females, patients with underlying cardiovascular disease, asthma and chronic obstructive airway disease, those who received symptomatic care, and patients with myalgia and headaches at COVID-19 diagnosis were more likely to have long COVID. Three patients with suspected severe mental health problems were referred to the district psychologist, and ten patients with no/incomplete vaccination were referred for vaccination.. Long COVID is highly prevalent among COVID-19 patients in Port Dickson, Malaysia. Long-term surveillance and management of long COVID, especially among the high-risk groups, are needed as we transition to living with COVID-19.

Topics: Adult; COVID-19; COVID-19 Testing; Female; Headache; Humans; Malaysia; Male; Myalgia; Post-Acute COVID-19 Syndrome; Retrospective Studies; SARS-CoV-2

Data on the prevalence of nontraumatic headaches with red flag symptoms in Asia are sparse. Therefore, the objectives of this study were to determine the final diagnosis and prevalence of abnormal CT scans in patients who presented to the emergency department (ED) with red flag symptoms.. This was a retrospective study based on the Radiology Department database of patients who presented to the ED with complaints of nontraumatic headache, had red flag symptoms, and underwent cranial CT scans. The inclusion criteria were adult patients presenting through the ED with nontraumatic headache who underwent cranial CT scans. Multivariate analysis was performed based on logistic regression to analyse the significance of the predictive value for abnormal CT scans.. A total of 216 patients underwent cranial CT scans in the ED. More than half of the cases (53.7%) were male. A total of 146 patients (67.6%) had no obvious abnormalities in the CT scans, while 41 patients (19.0%) had cranial infarction, 9 patients (4.2%) had intracranial bleeding, and 20 patients (9.3%) had brain tumours. The most common diagnosis was primary headache syndrome, followed by cerebral vascular accident (CVA). Multivariate analysis showed that three factors were associated with abnormal CT scans: age, systolic blood pressure (SBP), and mean arterial pressure (MAP). New onset of headache at the age of 50 years or older (Odds Ration, OR 3.21, 95% Confidence Interval, CI 1.15, 8.94), SBP (OR 4.82. 95%CI 2.29, 10.40) and MAP (OR 6.21, 95%CI 2.71, 14.70) were significant.. The prevalence of abnormal CT scan findings in nontraumatic headache patients with red flag symptoms was 32%. Primary headache syndrome is the most common diagnosis. An age greater than 50 years old during the onset of headache, SBP greater than 180mmHg and MAP greater than 120mmHg were associated with a higher risk of abnormal cranial CT scans.

Topics: Adult; Emergency Service, Hospital; Female; Headache; Headache Disorders; Hospitals; Humans; Malaysia; Male; Middle Aged; Prevalence; Retrospective Studies; Tomography, X-Ray Computed

Topics: Anti-Bacterial Agents; Aspartate Aminotransferases; Doxycycline; Female; Fever of Unknown Origin; Headache; Hemoglobins; Humans; Malaysia; Middle Aged; Myalgia; Orientia tsutsugamushi; Scrub Typhus; Skin Diseases; Travel; Travel-Related Illness

There are few studies on rhinitis and sick building syndrome (SBS) among students in tropical countries. We studied associations between levels of five fungal DNA sequences, two mycotoxins (sterigmatocystin and verrucarol) and cat allergen (Fel d 1) levels in schools and rhinitis and other weekly SBS symptoms in the students. Fungal DNA was measured by quantitative PCR and cat allergen by ELISA. Pupils (N = 462) from eight randomly selected schools in Johor Bahru, Malaysia participated (96%). Dust samples were collected by cotton swabs and Petri dishes exposed for one week. None of the schools had a mechanical ventilation system, but all classrooms had openable windows that were kept open during lectures and indoor CO2 levels were low (mean 492 ppm; range 380-690 ppm). Weekly nasal symptoms (rhinitis) (18.8%), ocular (11.6%), throat (11.1%), dermal symptoms, headache (20.6%) and tiredness (22.1%) were common. Total fungal DNA in swab samples was associated with rhinitis (p = 0.02), ocular symptoms (p = 0.009) and tiredness (p = 0.001). There were positive associations between Aspergillus versicolor DNA in Petri dish samples, ocular symptoms (p = 0.02) and tiredness (p = 0.001). The level of the mycotoxin verrucarol (produced by Stachybotrys chartarum) in swab samples was positively associated with tiredness (p = 0.04). Streptomyces DNA in swab samples (p = 0.03) and Petri dish samples (p = 0.03) were negatively associated with tiredness. In conclusion, total fungal contamination, measured as total fungal DNA) in the classrooms, Aspergillus versicolor and verrucarol can be risk factors for rhinitis and SBS symptoms among students in the tropical country Malaysia.

Topics: Adolescent; Allergens; Animals; Cats; DNA, Fungal; Dust; Eye; Fatigue; Female; Headache; Humans; Malaysia; Male; Models, Theoretical; Mycotoxins; Pharynx; Prevalence; Rhinitis; Schools; Skin; Students

Dyspepsia and headache frequently co-exist, but the clinical implication of this association is uncertain. We planned to examine the prevalence and impact of dyspepsia in adults with headache.. A cross-sectional study was conducted in a secondary care setting. Clinical, psychological and health-related quality of life (HRQOL) data were compared between subjects with headache and controls (non-headache subjects). The impact of dyspepsia was analysed further in subjects with headache alone.. 280 subjects (93 cases with headache and 187 matched controls) were recruited. The following baseline characteristics of subjects were as follows: mean age 45.0 ± 17.3 years, 57.0% females and ethnic distribution-Malaysian = 45 (48.4%), Chinese n = 24 (25.8%) and Indians n = 24 (25.8%). Headache sub-types among cases with headache were as follows: tension-type headache (TTH) n = 53 (57.0%) and migraine n = 40 (43.0%). Dyspepsia was more prevalent in cases with headache compared to controls (25.8% vs 12.8%, p = 0.011), and headache was independently associated with dyspepsia (OR 2.75, 95% CI 1.39-5.43). Among cases with headache, there was a trend towards a higher prevalence of dyspepsia in those with migraine (27.5%) compared to TTH (24.5%). Subjects with headache and dyspepsia, compared to those with headache alone, had a greater severity of headache symptoms (63.67 ± 22.85 mm vs 51.20 ± 24.0 mm VAS, p = 0.029). Overall HRQOL scores were lower in headache subjects with dyspepsia (EQ-5D summary score 0.82 ± 0.18 vs 0.90 ± 0.16, p = 0.037 and EQ-5D VAS 62.08 ± 17.50 mm vs 72.62 ± 18.85 mm, p = 0.018), compared to those without dyspepsia.. Dyspepsia is associated with more severe headache symptoms and results in a lower HRQOL in patients with headache.

Topics: Adult; Case-Control Studies; Cross-Sectional Studies; Dyspepsia; Female; Headache; Humans; Malaysia; Male; Middle Aged; Pain Measurement; Prevalence; Quality of Life; Risk Factors

In May 2014, six patients presented in Germany with a Sarcocystis-associated febrile myositis syndrome after returning from Tioman Island, Malaysia. During two earlier waves of infections, in 2011 and 2012, about 100 travellers returning to various European countries from the island were affected. While the first two waves were associated with travel to Tioman Island mostly during the summer months, this current series of infections is associated with travel in early spring, possibly indicating an upcoming new epidemic.

Topics: Adolescent; Anti-Infective Agents; Child; Female; Fever; Germany; Headache; Humans; Infant; Malaysia; Male; Myalgia; Prednisolone; Sarcocystis; Sarcocystosis; Travel; Trimethoprim, Sulfamethoxazole Drug Combination

Pyrexia of unknown origin (PUO) is a frequent presentation to the Acute Medical Unit, and is a source of significant morbidity, both the psychological burden of an uncertain diagnosis and prognosis and untreated complications of the underlying pathology. We present a problem based review of the management of PUO, illustrated by a patient who recently presented to our unit with fever and systemic malaise after returning from abroad and in whom no cause could be found for more than two months. We describe a structured approach making use of complex modern techniques such as Positron Emission Tomography-Computed Tomography (PET-CT) which ultimately provided the diagnosis for our patient.

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Anti-Infective Agents; Anti-Inflammatory Agents; Aorta; Aortography; Arthralgia; Aspirin; Diagnosis, Differential; Female; Fever of Unknown Origin; Headache; Humans; Lansoprazole; Malaysia; Middle Aged; Multimodal Imaging; Positron-Emission Tomography; Prednisolone; Singapore; Takayasu Arteritis; Tomography, X-Ray Computed; Treatment Outcome

Topics: Adult; Animals; Culicidae; Dengue; Dengue Virus; Diagnosis, Differential; Exanthema; Fever; Headache; Humans; Malaysia; Male; Nausea; Singapore; Travel; Tropical Medicine

Topics: Asian; Chronic Disease; Head; Headache; Humans; Incidental Findings; Malaysia; Male; Medicine, Traditional; Middle Aged; Neck; Needles; Radiography, Thoracic; Subcutaneous Tissue; Tomography, X-Ray Computed

This study presents the first account of the racial differences in headache prevalence and characteristics in the Singapore population. A questionnaire was administered to 2096 individuals from a randomized sample of 1400 households to test the hypothesis that race was independently correlated with headache diagnosis and morbidity. The overall lifetime prevalence of headaches in the study population was 82.7%; this did not vary between racial groups. The modal age of headache onset in all races was in the second decade and was similar in all races. Multivariate analysis showed that headache morbidity was independent of age, sex, income level, marital status, shift duties, and educational level, and correlated only with race and a positive family history of severe headache. Non-Chinese were more likely to suffer from severe headaches than Chinese, were more likely to seek medical attention, and were more likely to require medical leave for their symptoms. Non-Chinese had more migrainous headaches than Chinese, although characteristics of headache both groups experienced that were unrelated to severity differed only in a few aspects. We conclude that racial factors account for differences in headache classification, perception of headache severity and health-seeking behavior.

Topics: Adolescent; Adult; Aged; Asian People; China; Female; Headache; Health Behavior; Health Surveys; Humans; India; Malaysia; Male; Middle Aged; Prevalence; Random Allocation; Singapore

This community study on headache in Malaysia was based on IHS diagnostic criteria and showed the last-year prevalence of migraine was 9.0%. Migraine with aura accounted for only 10.6% of the migrainous population. The last-year prevalence of tension headache was 26.5% (94.4% episodic, 5.6% chronic) and 28.2% for other types of headache. No case of cluster headache was found. Almost two thirds of the migraine subjects graded their headaches as severe, while almost 60% of the tension headache subjects and almost 70% of the other headache subjects graded their headaches as mild. Overall, there was higher prevalence in females for migraine and tension headache, and in males for the other types of headache. The prevalence of headache was lower among those younger than 15 and older than 65 years of age. No significant differences were found in the prevalence of headache among the different racial groups nor among the urban versus the rural population. All the headache types shared the same triggering factors suggesting that different physiological characteristics are responsible for the type of pain suffered. In the location of this community with its tropical climate, headache was attributed to sun exposure in 51.9% of the migraine subjects, 55.7% of the tension headache subjects, and 36.6% of the group with other headaches.

Topics: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Child; Child, Preschool; Female; Headache; Humans; Malaysia; Male; Middle Aged; Prevalence; Rural Population; Severity of Illness Index; Sex Distribution; Urban Population

In a retrospective analysis of paediatric referrals to a Neurology Outpatient Clinic, the largest single category of 47 patients (32%) presented with acute recurrent headache. There were 30 girls and 17 boys. Age of onset ranged from 4 to 11 years (8.35 +/- 1.98) and duration of headache from half month to 42 months (19.2 +/- 11.9). Only 6 children were unable to describe the quality of their pain. Using conventional criteria, 43 of the children could be classified as classical migraine (10), common migraine (20), basilar migraine (3), ophthalmoplegic migraine (1) and tension tension headache (9). None had any positive physical signs, and all responded to simple measures.

Topics: Child; Child, Preschool; Female; Headache; Humans; Malaysia; Male; Prevalence; Recurrence; Retrospective Studies

A study of 1,437 unselected febrile patients in rural Malaysia yielded a diagnosis of leptospirosis in 86 (6.0%). The clinical syndrome was mild to moderate in all cases, jaundice was observed in only 2 (2.3%) and no deaths were documented. The diagnosis was not clinically obvious in most cases, and it is apparent that many infections must be going unnoticed at present.

Topics: Fever; Headache; Humans; Jaundice; Leptospirosis; Malaysia