Wednesday, 13 October 2010
Monday, 11 October 2010
Sunday, 10 October 2010
Friday, 8 October 2010
Wednesday, 6 October 2010
Tuesday, 5 October 2010
Tuesday, 28 September 2010
Outcomes After Cardiopulmonary Resuscitation in Intensive Care Units
Critically ill patients, especially those requiring hemodynamic support, are unlikely to survive cardiopulmonary arrests.
Using national registry data from >400 intensive care units (ICUs), researchers examined outcomes of 49,656 adults (median age, 69) who suffered first cardiopulmonary arrests (CPAs) while in the ICU between 2000 and 2008. Overall rate of survival to hospital discharge was 15.9%.
Using national registry data from >400 intensive care units (ICUs), researchers examined outcomes of 49,656 adults (median age, 69) who suffered first cardiopulmonary arrests (CPAs) while in the ICU between 2000 and 2008. Overall rate of survival to hospital discharge was 15.9%.
Monday, 23 August 2010
Wednesday, 18 August 2010
Kuliah Ramadan By KMC Consultants.
KEDAH.FM – 97.5
Kuliah Ramadhan - Radio Malaysia Kedah (RTM)
Dr Wan Mohd Rushidi Wan Mahmud
“REMAJA”
19hb Ogos 2010 (Thursday)
Dr Abdul Razif Abd Razak
“FARDHU KIFAYAH”
5hb September 2010 (Sunday)
Radio Kedah FM : 1.45 pm – 2.30 pm
Location : Surau Insaniah, KUIN.
PUSAT DAKWAH ISLAM, ALOR SETAR
Yayasan Islam Negeri Kedah
Dato’ Dr Ismail Bin Yaacob
“PUASA DARI SUDUT PERUBATAN”
25hb Ogos 2010 (Wednesday)
12.45 pm -1.45 pm
Dr Sharifah Khatijah Syed Hassan Barakbah
KEUPAYAAN PUASA KANAK-KANAK”
26hb Ogos 2010 (Thursday)
12.45 pm -1.45 pm
Thursday, 5 August 2010
Wednesday, 4 August 2010
Tuesday, 3 August 2010
Monday, 2 August 2010
Sunday, 1 August 2010
Public Lecture : 'Kanser Prostat' by Mr Murali - 9.8.2010
Monday : 9.8.2010 - 9.30 - 11.am - Level 8, Kedah Medical Centre.
Saturday, 31 July 2010
Calcium Supplements Reportedly Raise Risk for Myocardial Infarction
Patients on calcium supplements show a modest increase in risk for myocardial infarction, according to a BMJ meta-analysis.
Investigators gathered data on some 12,000 participants in randomized controlled trials using calcium supplements without vitamin D. Subjects on calcium showed a roughly 30% increase in risk for MI and nonsignificant increases for stroke, death, and the composite outcome of MI, stroke, or sudden death.
Investigators gathered data on some 12,000 participants in randomized controlled trials using calcium supplements without vitamin D. Subjects on calcium showed a roughly 30% increase in risk for MI and nonsignificant increases for stroke, death, and the composite outcome of MI, stroke, or sudden death.
Thursday, 29 July 2010
Tuesday, 20 July 2010
Monday, 19 July 2010
Public Lecture : 'Gangguan Jiwa Wanita' : 18.07.2010 (Dr Wan)
Program: Sayangi Diri Sayangi Keluarga (Majalah Wanita)
Holiday Villa, Alor Setar, Kedah.
Friday, 16 July 2010
Wednesday, 30 June 2010
Early Dialysis Not Necessarily Better in Chronic Kidney Disease
In patients with chronic kidney disease, outcomes are similar regardless of the planned timing of dialysis, according to a New England Journal of Medicine study.
Researchers in Australia and New Zealand randomized some 830 adults with progressive, end-stage renal disease to early initiation of dialysis (when estimated glomerular filtration rate reached 10-14 ml/minute) or late initiation (eGFR, 5-7 ml/minute). Ultimately, dialysis began an average of 5.5 months earlier in the early-start group. About three-fourths of "late-start" patients actually began dialysis when eGFR was above 7 ml/minute, owing to symptoms such as uremia.
Researchers in Australia and New Zealand randomized some 830 adults with progressive, end-stage renal disease to early initiation of dialysis (when estimated glomerular filtration rate reached 10-14 ml/minute) or late initiation (eGFR, 5-7 ml/minute). Ultimately, dialysis began an average of 5.5 months earlier in the early-start group. About three-fourths of "late-start" patients actually began dialysis when eGFR was above 7 ml/minute, owing to symptoms such as uremia.
Wednesday, 23 June 2010
Public Talk - 'Bijak Berfikir Cerah Masa Depan' - Dr Wan
This was part of a one day program organized by MEC Kedah Medical Centre with the cooperation from Kedah's National Population and Family Development Board Malaysia (LPPKN) and SMK Tengku Laksamana Parents Teacher Association on June 22nd, 2010.
Location
SMK Tengku Laksamana, Jalan Kuala Kedah, Alor Setar, Kedah
Thursday, 3 June 2010
Sunday, 30 May 2010
Case : Dysphasia – Dysuria – Disaster
http://www.medicalprotection.org/uk/casebook-september-2009/case-reports/Dysphasia-dysuria-disaster
Mr W, a 70-year-old retired shoe mender, went to his GP surgery because he was experiencing difficulty passing urine. He had previously suffered a stroke leaving him with marked speech difficulty, so verbal communication was not easy. His main complaints were of dysuria, bouts of urinary incontinence and a split urinary stream. His symptoms had come on gradually and worsened over the course of a year.
Mr W, a 70-year-old retired shoe mender, went to his GP surgery because he was experiencing difficulty passing urine. He had previously suffered a stroke leaving him with marked speech difficulty, so verbal communication was not easy. His main complaints were of dysuria, bouts of urinary incontinence and a split urinary stream. His symptoms had come on gradually and worsened over the course of a year.
Monday, 24 May 2010
Friday, 23 April 2010
Accuracy of X-Rays for Detecting Hip and Pelvis Fractures : Both false-positives and false-negatives are not uncommon.
X-ray imaging of the hip and pelvis can miss acute fractures. In a retrospective study to determine the accuracy of radiography, Duke University researchers identified 92 consecutive patients (mean age, 71) who received hip or pelvis x-rays in the emergency department and then underwent hip or pelvis magnetic resonance imaging (MRI) within 1 day. Falls and motor vehicle trauma were the usual indications for radiography. Key findings were as follows:
Tuesday, 6 April 2010
Tuesday, 23 March 2010
Risk Factors for Chronic Pain after Hysterectomy: A Nationwide Questionnaire and Database Study
Brandsborg, Birgitte M.D.; Nikolajsen, Lone M.D., Ph.D.; Hansen, Charlotte T. M.D.; Kehlet, Henrik M.D., Ph.D.; Jensen, Troels S. M.D., Ph.D.
Abstract
Background: Women scheduled to undergo hysterectomy for benign indications frequently have preoperative pelvic pain, but it is largely unknown why pain in some cases persists or even develops after surgery. This nationwide questionnaire and database study describes pain and identifies risk factors for chronic postsurgical pain 1 yr after hysterectomy for benign indications.
Abstract
Background: Women scheduled to undergo hysterectomy for benign indications frequently have preoperative pelvic pain, but it is largely unknown why pain in some cases persists or even develops after surgery. This nationwide questionnaire and database study describes pain and identifies risk factors for chronic postsurgical pain 1 yr after hysterectomy for benign indications.
Toxicity, Benzodiazepine: Treatment & Medication
http://emedicine.medscape.com/article/813255-treatment
eMedicine Specialties > Emergency Medicine > Toxicology
Updated: Jan 28, 2010
Introduction
Background
Benzodiazepines (BZDs) are sedative-hypnotic agents that were first introduced in 1960. BZDs commonly are used for a variety of situations that include seizure control, anxiety, alcohol withdrawal, insomnia, control of drug-associated agitation, as muscle relaxants, and as preanesthetic agents. They also are combined frequently with other medications for procedural sedation.
Because of their widespread use, these drugs have propensity for abuse. In addition, benzodiazepines frequently are used in overdose, either alone or in association with other substances.
eMedicine Specialties > Emergency Medicine > Toxicology
Updated: Jan 28, 2010
Introduction
Background
Benzodiazepines (BZDs) are sedative-hypnotic agents that were first introduced in 1960. BZDs commonly are used for a variety of situations that include seizure control, anxiety, alcohol withdrawal, insomnia, control of drug-associated agitation, as muscle relaxants, and as preanesthetic agents. They also are combined frequently with other medications for procedural sedation.
Because of their widespread use, these drugs have propensity for abuse. In addition, benzodiazepines frequently are used in overdose, either alone or in association with other substances.
High-Dose Simvastatin May Increase Risk for Muscle Injury, FDA Warns
Patients who are taking the highest approved dose of the cholesterol-lowering drug simvastatin (Zocor) may face increased risk for muscle injury compared with those taking lower doses or "possibly" other statins, the FDA warned on Friday.
Monday, 22 March 2010
Sunday, 28 February 2010
Metformin and Vitamin B12 Deficiency
Evidence suggests that metformin lowers vitamin B12 levels in patients with diabetes.
Observational studies have suggested that metformin causes vitamin B12 deficiency in some patients; researchers have proposed several possible mechanisms whereby metformin might interfere with B12 absorption. Understanding this interaction is important, because B12 deficiency could exacerbate neuropathic symptoms in patients with diabetes.
In this prospective case-control study, Canadian investigators identified 122 type 2 diabetic patients with peripheral neuropathy: Half had taken metformin for at least 6 months, and half had never received metformin. Otherwise, clinical characteristics of the groups were similar.
Observational studies have suggested that metformin causes vitamin B12 deficiency in some patients; researchers have proposed several possible mechanisms whereby metformin might interfere with B12 absorption. Understanding this interaction is important, because B12 deficiency could exacerbate neuropathic symptoms in patients with diabetes.
In this prospective case-control study, Canadian investigators identified 122 type 2 diabetic patients with peripheral neuropathy: Half had taken metformin for at least 6 months, and half had never received metformin. Otherwise, clinical characteristics of the groups were similar.
Wednesday, 17 February 2010
Tuesday, 16 February 2010
Thursday, 28 January 2010
Cardiovascular Benefit of Glycemic Control Is Limited to Those with Low Comorbidity
Does an HbA1c level of 7% remain an appropriate goal?
The effect of glycemic control on preventing adverse cardiovascular events has been difficult to demonstrate, possibly because such effects are limited to particular patient subgroups.
To determine whether achieving glycosylated hemoglobin (HbA1c) targets of 7% versus 6.5% had differential effects by comorbidity, industry-sponsored researchers studied 2613 Italian patients with type 2 diabetes who received care from general practitioners or in diabetes clinics. Comorbidity was measured by questionnaire and was dichotomized at a level that was associated with excess mortality. Comorbidities included heart disease, lung disease, arthritis, genitourinary disease, vision loss, adverse gastrointestinal conditions, and foot disease.
The effect of glycemic control on preventing adverse cardiovascular events has been difficult to demonstrate, possibly because such effects are limited to particular patient subgroups.
To determine whether achieving glycosylated hemoglobin (HbA1c) targets of 7% versus 6.5% had differential effects by comorbidity, industry-sponsored researchers studied 2613 Italian patients with type 2 diabetes who received care from general practitioners or in diabetes clinics. Comorbidity was measured by questionnaire and was dichotomized at a level that was associated with excess mortality. Comorbidities included heart disease, lung disease, arthritis, genitourinary disease, vision loss, adverse gastrointestinal conditions, and foot disease.
More Evidence Against Too-Intensive Glucose Control in Type 2 Diabetes
The most intensive glucose control is associated with increased risk for death, according to a retrospective cohort study published online in the Lancet.
Using a U.K. general practice database, researchers identified two diabetic cohorts together comprising some 48,000 patients whose treatments had been intensified. One cohort started treatment with oral glucose-lowering monotherapy and switched to a combination therapy using a sulfonylurea plus metformin. The other cohort switched from oral agents alone to insulin with or without oral agents.
Using a U.K. general practice database, researchers identified two diabetic cohorts together comprising some 48,000 patients whose treatments had been intensified. One cohort started treatment with oral glucose-lowering monotherapy and switched to a combination therapy using a sulfonylurea plus metformin. The other cohort switched from oral agents alone to insulin with or without oral agents.
Sunday, 24 January 2010
Friday, 22 January 2010
Should Physicians Be 'Punished' For Not Washing Their Hands?
(original article - Medscape : http://boards.medscape.com/forums?128@659.WQ45aiaDlWk@.29f8f873!comment=1
by Leslie Kane, Other, 10:10AM Jan 14, 2010
Hospitals and healthcare organizations have made it a major goal to get physicians (and other health workers) to wash their hands more frequently, in order to prevent cross-contamination. While there are pockets of success, most efforts have been as useful as warning teenagers to put down the cell phone while driving.
by Leslie Kane, Other, 10:10AM Jan 14, 2010
Hospitals and healthcare organizations have made it a major goal to get physicians (and other health workers) to wash their hands more frequently, in order to prevent cross-contamination. While there are pockets of success, most efforts have been as useful as warning teenagers to put down the cell phone while driving.
Wednesday, 13 January 2010
Interesting Article : Combined Antiplatelet and Anticoagulant Drugs Raise Bleeding Risk
Summary and Comment
Combined Antiplatelet and Anticoagulant Drugs Raise Bleeding Risk
Use of dual or triple therapy requires caution.
Aspirin and clopidogrel are recommended for patients after acute myocardial infarction (AMI), and many AMI patients also have indications for a vitamin K antagonist. But combining these drugs can elevate risk for bleeding, which in turn can lead to morbidity and mortality.
Combined Antiplatelet and Anticoagulant Drugs Raise Bleeding Risk
Use of dual or triple therapy requires caution.
Aspirin and clopidogrel are recommended for patients after acute myocardial infarction (AMI), and many AMI patients also have indications for a vitamin K antagonist. But combining these drugs can elevate risk for bleeding, which in turn can lead to morbidity and mortality.
Tuesday, 12 January 2010
KMC Consultant In the Media : Dr Wan (11.01.2010)
Utusan Malaysia (Page:12) : Forum
Berita Harian - (Page 28) : Surat & E-mel
Thursday, 7 January 2010
Interesting Article : Recommendations for Prescribing NSAIDs
December 28, 2009 — A review article published in the December 15 issue of the American Family Physician offers recommendations for prescribing nonsteroidal anti-inflammatory drugs (NSAIDs) in the primary care setting.
"...NSAIDs are commonly used to treat inflammation, pain, and fever by decreasing prostaglandin synthesis through blockage of the cyclooxygenase (COX) enzyme," write Amanda Risser, MD, MPH, from Oregon Health and Science University in Portland, and colleagues. "The two major isoforms of COX (COX-1 and COX-2) are inhibited by nonselective NSAIDs. COX-2 is also inhibited by selective NSAIDs. All nonselective NSAIDs inhibit platelet aggregation through inhibition of COX-1 and the thromboxane A2 (TXA2) pathway."
"...NSAIDs are commonly used to treat inflammation, pain, and fever by decreasing prostaglandin synthesis through blockage of the cyclooxygenase (COX) enzyme," write Amanda Risser, MD, MPH, from Oregon Health and Science University in Portland, and colleagues. "The two major isoforms of COX (COX-1 and COX-2) are inhibited by nonselective NSAIDs. COX-2 is also inhibited by selective NSAIDs. All nonselective NSAIDs inhibit platelet aggregation through inhibition of COX-1 and the thromboxane A2 (TXA2) pathway."
Interesting Article : Smoking Cessation Associated with Short-Term Increase in Diabetes Risk
Adults who quit smoking face increased risk for type 2 diabetes during the first several years after quitting, according to an Annals of Internal Medicine study.
Researchers followed nearly 11,000 middle-aged adults for roughly 9 years, during which about 12% developed diabetes. Compared with adults who never smoked, those who continued smoking during follow-up had a roughly 30% elevated risk for diabetes, while those who quit smoking by year 3 had almost a 75% increase in risk. The elevated risk among these new quitters seemed to be mediated by adverse metabolic changes, including weight gain and systemic inflammation.
Researchers followed nearly 11,000 middle-aged adults for roughly 9 years, during which about 12% developed diabetes. Compared with adults who never smoked, those who continued smoking during follow-up had a roughly 30% elevated risk for diabetes, while those who quit smoking by year 3 had almost a 75% increase in risk. The elevated risk among these new quitters seemed to be mediated by adverse metabolic changes, including weight gain and systemic inflammation.
Tuesday, 5 January 2010
MEC Talk - January 2010 : Dr Chua May Wah
Speaker
Dr Chua May Wah (Consultant Paediatrician)
Topic
Premature Babies
Date
Thursday : 14 January 2010 (8.30 am - 9.30 am)
Location
Seminar Room, Level 8, Kedah Medical Centre
Saturday, 2 January 2010
MEC KMC List of Activities for 2009
The list of activities conducted by the Medical Education Committee for the Year 2009 can be accessed at these addresses :
We would like to take this opportunity to thank all the consultants and members of the staff in KMC for their contributions and hard work. Hopefully we will be able to improve on our performance further this year.
Thank you.
MEC KMC (2009-2010)
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