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.

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

MEC Special Lecture : Analysis of Culture & Sensitivity: Specimens from KMC 2001 & 2009 - 2.6.2010 (Dr Sarwan)

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.

MEC Special Lecture: Radiotherapy in Cancer Treatment

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:

World Health Day & Public Talk in KMC - 7.4.2010

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.

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.

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.

Public Lecture : Stress Management : Dr Wan (TM Office Alor Setar) - 22.3.2010

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.

MEC Talk : MRI

KMC Consultant In the Media : Dr Kamaruzzaman Ali

New Straits Times (14.02.2010 : V5)

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.

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.

TNB Safety Day 21.01.2010

Public Talk : Dr Syed Faisal (30.01.2010)

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.

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.

KMC Consultant In the Media : Dr Wan (11.01.2010)

Utusan Malaysia (Page:12) : Forum

Berita Harian - (Page 28) : Surat & E-mel

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."

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.

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

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 :

MEC KMC - MEC Activities in KMC 2009
MEC KMC - Public Talk 2009

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)

Public Talk - Dr Wan : Stress & Mental Health

Public Talk by Dr Wan Rushidi on Stress & Mental Health 10.10.2009 in conjuction with the World Mental Health Day 2009.

Special Lecture on H1N1

Special Lecture H1N1 given by the Ministry of Health - 10.09.2009

Kuliah Ramadan by KMC Consultants at Kedah FM

Kedah FM : 1.45 -2.30 pm - Live from Surau Insaniah

24/08/2009 - Dr Abdul Razif Abdul Razak (Lentur Buluh)
27/08/2009 - Dr Zuraini Abdul Hamid (Korban Ibu)
07/09/2009 - Dr Wan Mohd Rushdi Wan Mahmud (Tenang Hati)
10/09/2009 - Dr Riduan Soh Kam Lung (Ana Muslim)

Happy Listening

MEC Talk : September 2009

The Things I have Never Learnt In Medical School

by

Dr. Ho Kok Chuan (Consultant General Surgeon)

Thursday 03.09.2009 - 8.30 - 9.30 am

8th Floor, Seminar Room, Kedah Medical Centre,
All are invited.Thank you.

MEC Lecture : Dr Chew (13.8.2009)

Public Lecture : Stress & Mental Health - SMK Tun Syarifah Rodziah 12.08.2009 (Dr Wan)

Medical Lecture : How To Quit Smoking

This lecture was given by Dr Edward Nathan, a guest speaker from Penang Adventist Hospital. A very informative lecture indeed.

Public Lectures : TNB Safety Day - Dr Ismayatim / Dr Muhammad / Dr Wan (27.7.2009)

CPR Course for TNB Staffs

Special CPR Course arranged for the staffs from Tenaga Nasional Berhad -

Kedah Medical Centre 23.7.2009

MEC Talk July 2009

Infertility

by
Dr. Kamaruzzaman Ali (Consultant Obstetrician & Gynaecologist)

Thursday 16.07.2009 8.30 - 9.30 am

All are invited.
Thank you.

Public Lecture : Drug Addiction - SK Seberang Nyonya (Dr Wan) - 11.7.2009

Medical Health Talk - Obesity by Dr Mani Sekar - 20.06.2009

WHO Website on Influenza A (H1N1)

Please go to the address below on the latest update :

http://www.who.int/csr/disease/swineflu/en/

H1N1 Influenza (Swine Flu)

Article on H1N1 Influenza (Swine Flu) in Medscape
and the Medscape's H1N1 influenza algorithm adaptation

Medical Director in the Media : SINAR (13.5.2009 : U4)

Public Education Service : Talk by Dr Wan Rushidi (23.05.2009)

Public Talk by Dr Wan Mohd Rushidi Wan Mahmud

(Consultant Neuro-Behaviour Medicine)

Topic

Stress Management

Location

Seminar Room KMC - 8th Floor
Date

Sabtu, 23 May 2009
Time
8.30 am – 11.00 am

Please call Puan Nor Ashikin / Puan Siti Mahani / Encik Fathuddin Riyadz / Puan Norlia for reservation ---> 04-737 3308 / 3307 / 3304

MEC Talk - May 2009

Mood Disorder

by

Dr Wan Mohd Rushidi Bin Haji Wan Mahmud (Consultant Neuro-Behaviour Medicine)

(Thursday : 14.05.2009 - 8.30 - 9.30 am)

All are invited.

Thank you.

Special Talk : Retardation of Renal Failure by Dr Syed Faisal Taha (28.4.2009)

KMC Consultant in the Media (SINAR - 24.4.2009 : U6)

Special Talk : Retardation of Kidney Failure - 28.4.2009

Retardation of Kidney Failure

by
Dr Syed Faisal Taha (Visiting Consultant Nephrologist)
(28.4.2009 - 8.00 - 9.00 am)
All are invited.
Thank you.

MEC Talk - April 2009

Allergic Rhinitis
by
Dr Mahfudz Zakaria (Consultant ENT Surgeon)
(Thursday : 21.04.2009 - 8.30 - 9.30 am)
All are invited.
Thank you.

KMC Consultant in the Media (SINAR - 13.4.2009 : U6)

KMC Consultant in the Media : SINAR 2.4.2009 - U6

KMC Consultant in the Media : SINAR 30.3.2009 - U6

Public Educational Service : Basic CPR Course (30.3.2009) in Kampung Telok Layang

Today KMC Medical Education Committee has organized a public educational service - CPR Course in TABIKA Kampung Telok Layang, Jalan Kuala Kedah.

A group of 20 mothers from around the nearby village was invited to attend the course. They were indeed very thankful to KMC for organizing such an event.

MEC Talk - March 2009

MEC Talk for March 2009
Arthroscopic Surgery by Dr Jasminder Singh (Consultant Orthopaedic Surgeon)
(Thursday : 26.03.2009 - 8.30 - 9.30 am)
All are invited.
Thank you.

Pictures From The Latest MEC Talk by Dr. Zamri

Article on Stress & Strokes (STAR : 8/2/09 - SF12)

Lecture on Pain Management

MEC Talk for February 2009

Pain Management by Dr Zamri Jamingan (Consultant Anaesthetist)

(Thursday : 12/02/09 - 8.30 - 9.30 am)

All are invited.

Thank you.

Chikungunya Fever

Our first MEC Talk for the year 2009 will be as follows :

• Topic - Chikungunya Fever
• Consultant - Dr Ismayatim Ahmad (Consultant Physician)
• Date - Thursday : 22/01/09 (8.30 - 9.30 am)
• Place - 8th Floor - Seminar Room

Thank you

http://www.cdc.gov/ncidod/dvbid/Chikungunya/CH_FactSheet.html

http://en.wikipedia.org/wiki/Chikungunya

Welcome to KMC Medical Education Blog

Dear all,

As this is our first post, I would like to take the opportunity to thank and welcome all of you to our new blog. This is one of our new initiatives aimed at providing medical education to both the health care professionals (particularly general practitioner) and to the general community.
We have with us about 28 full time consultants and 4 visiting consultants, all of whom are forever willing help in any way they can.

Thank you