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Biomedical subjects

M Paramsothy

Publications and source records attributed to M Paramsothy.

At least 19 recordsLinked to original sources
PubMed2000

Profile of a menopause clinic in an urban population in Malaysia.

The object of this study is to determine the status of an urban Malaysian woman in her menopause age group with reference to her menopausal symptoms, lipid profile, breast, pelvis and bone. One hundred and sixty four women attending the Menopause Clinic of University Hospital, Kuala Lumpur who had not previously been on hormone replacement therapy were studied. Forty nine women were perimenopausal, 74 women were in early menopause (within 5 years of menopause) and 41 women were in late menopause (after 5 years of menopause). The most common symptoms were hot flushes (56%) and generalised tiredness (49%). Eighty four percent (84%) of women had high cholesterol levels. Serum triglycerides were highest in the late menopause group. There were 2 cases of intraductal carcinoma diagnosed on routine mammography, with 8 cases of fibrocystic breast disease and 7 cases of suspicious breast lumps. Routine ultrasound (pelvic and abdominal) revealed two women with ovarian cysts, 6 women with an endometrial thickness of more than 5 mm and 8 women with uterine fibroids. Eighty five women (51.8%) had mild osteoporosis while four women had moderate osteoporosis on dual photon measurements for bone mineral density. Menopause clinics should aim at investigating a woman in her menopause as a whole. Vasomotor symptoms were common in the urban Malaysian menopausal woman. There was a high incidence of lipid abnormalities. Routine mammography, pelvic ultrasound examinations and bone mineral density tests detected significant pathology and abnormalities.

Aged↗
PubMed1999

Value of routine 99mTc-MDP bone scintigraphy in the detection of occult skeletal metastases in women with primary breast cancer.

Baseline staging bone scans in 208 women with primary breast cancer in University Hospital Kuala Lumpur from January 1993 to December 1995 were reviewed. A positive bone scan was found in 14.7% of women aged below 50 years, and 9.1% of women aged 50 years and above. No patient with T0/T1, 4.7% with T2, 6.6% with T3 and 35.8% with T4 tumours had a positive scan caused by bone metastases. No patient with clinical Stage 0/1, 4% with Stage 2, 9.5% with Stage 3 and 63% with Stage 4 disease had a positive bone scan. Clinical staging alone was inaccurate in 20.2% of patients. Forty per cent of patients with a positive bone scan did not have bone pain. The false positive rate was 0.5% and the false negative rate was 0.96%. We conclude that a routine bone scan is not required in Stage 1 disease or T1 tumours, is indicated in Stage 3 and 4 disease, or T3 and T4 tumours, and should only be performed in selected women with Stage 2 or T2 cancers.

Journal Article↗
PubMed1997

Does Helicobacter pylori infection affect gastric emptying in patients with functional dyspepsia?

The objectives of the study were first, to determine if gastric emptying was altered in patients with functional dyspepsia with and without Helicobacter pylori infection compared with normal healthy volunteers; and second, to determine if there were further alterations in gastric emptying when the infection was eradicated. Gastric emptying was measured using a 99mtechnetium radiolabelled solid meal and gastric emptying time was measured as t1/2, viz. time taken for half the radiolabelled meal to be emptied from the stomach. The mean gastric emptying time for H. pylori-positive patients (n=20) was 56.4+/-24.8 min; H. pylori-negative patients (n=19) 67.8+/-31.8 min; and normal controls (n=20) 58.8+/-18.8min. No significant difference was obtained between the groups (ANOVA; P=0.348). Thirteen of 18 H. pylori-positive patients successfully eradicated the infection following treatment with omeprazole 40 mg o.m. and amoxycillin 500 mg t.d.s. for 2 weeks. The mean difference in the gastric emptying time before and after H. pylori eradication was 23.9+/-13.2 min (P= 0.556). There was no significant difference in the frequency of specific dyspeptic symptoms as well as the overall mean symptom score between the H. pylori-positive and -negative patients. Gastric emptying was not different between patients with functional dyspepsia and normal controls. Helicobacter pylori infection does not appear to affect gastric emptying in patients with functional dyspepsia.

Adolescent↗
PubMed1997

Use of gallium-67 in the assessment of response to antibiotic therapy in malignant otitis externa--a case report.

Malignant Otitis Externa (MOE) can cause considerable morbidity and mortality in affected individuals. The outlook is now much improved with the use of ciprofloxacin, but it is important to ascertain that the infection has been completely eradicated before stopping treatment, as undertreatment may lead to a recurrence which is usually more resistant than the initial infection. Gallium-67 Single Photon Emmision Computerised Tomography (SPECT) is a sensitive and cost effective tool in monitoring the disease activity of MOE, and should be used in the assessment of the response to antibiotic therapy.

Anti-Infective Agents↗
PubMed1997

The role of 67gallium scintigraphy and high resolution computed tomography as predictors of disease activity in sputum smear-negative pulmonary tuberculosis.

SETTING: University Hospital, Kuala Lumpur, Malaysia. OBJECTIVE: To determine whether 67Gallium (Ga) scintigraphy and high resolution computed tomography (HRCT) of the lung improve the diagnostic accuracy of sputum smear-negative active pulmonary tuberculosis. DESIGN: Patients suspected of having active pulmonary tuberculosis but who were sputum smear-negative underwent 67Ga scintigraphic and HRCT scanning of the lung. Results of these scans were correlated with results of bacteriology and histopathology as well as clinical data on follow-up. RESULTS: Although none of the patients was culture-positive for Mycobacterium tuberculosis, 14 were considered to have active disease either because of positive direct smears of respiratory tract specimens other than sputum, positive histopathology, or clinical and radiological improvement following antituberculosis chemotherapy. A positive 67Ga scan had a sensitivity of 100% and a specificity of 83% for active pulmonary tuberculosis. Of the HRCT findings, the presence of centrilobular lesions had a 93% sensitivity and 100% specificity in determining disease activity in this group of patients. CONCLUSION: Both 67Ga scintigraphic and HRCT scans are helpful in determining disease activity in sputum smear-negative pulmonary tuberculosis.

Female↗
PubMed1995

Oesophageal motility disorders: rapid functional diagnosis using computerised radionuclide oesophageal transit study.

Ten patients presenting with central chest pain and/or dysphagia were diagnosed to have oesophageal motility disorders (OMD) with an incoordinate motor function using computerised radionuclide oesophageal transit study (RT). The criteria for diagnosis of OMD with incoordination using RT were: an 'incoordinate' or 'to and fro' pattern characterised by multiple peaks of activity, prolonged total transit time or radionuclide bolus through entire length of oesophagus and a significant portion of bolus entering the stomach. These features are characteristic but not pathognomonic of diffuse oesophageal spasm (DES) as they are also seen in non-specific motility disorders (NSMD) and occasionally in order oesophageal motility disorders. Mechanical obstruction in the oesophagus and coronary artery disease were excluded appropriately in these patients. When manometry is not available, RT is a sensitive, safe, simple, rapid and non-invasive alternative modality in confirming certain oesophageal motility disorders.

Adult↗
PubMed1992

Results of long-term follow-up after compensated fixed-dose therapy for thyrotoxicosis.

To evaluate the effects of simple compensated fixed-dose iodine-131 therapy for thyrotoxicosis, the long-term results for 74 patients treated with a fixed dose of iodine-131 ranging from 5 to 12 mCi (185 to 444 MBq) were evaluated in the first 2 years of a trial. The dose selected was loosely based on the gross size of the thyroid gland. Routine antithyroid drug therapy was given for a minimum of 3 months after iodine-131 therapy. The mean (+/- SD) duration of follow-up was 74.5 +/- 42 months. The results indicated that roughly 25% of patients treated in this way will become hypothyroid after 5 years and that 85% are cured (need no further therapy during the follow-up period) using a single dose of iodine-131. Of those cured using a single iodine-131 dose, 81% were no longer receiving drugs after 6 months and 85% after 1 year. Such a regimen seems currently to be among the best available where prolonged periods of medication-free euthyroidism after therapy are sought.

Female↗
PubMed1987

Liver abscess in the tropics: experience in the University Hospital, Kuala Lumpur.

We reviewed 204 cases of liver abscess seen between 1970 and 1985. Ninety were found to be amoebic, 24 pyogenic and one tuberculous. The cause of the abscesses in the remaining 89 patients was not established. The patients were predominantly male, Indians, and in the 30-60 age group. The majority of patients presented with fever and right hypochondrial pain. The most common laboratory findings were leucocytosis, hypoalbuminaemia and an elevated serum alkaline phosphatase. Amoebic abscesses were mainly solitary while pyogenic abscesses were mainly multiple. Complications were few in our patients and included rupture into the pleural and peritoneal cavities and septicaemic shock. An overall mortality of 2.9% was recorded. The difficulty in diagnosing the abscess type is highlighted. The single most important test in helping us diagnose amoebic abscess, presumably the most common type of abscess in the tropics, is the Entamoeba histolytica antibody assay. This test should be used more frequently in the tropics.

Adult↗
PubMed1987

Cerebral metastases from choriocarcinoma. Results of chemotherapy.

Of 36 cases of choriocarcinoma treated at the University Hospital Kuala Lumpur during 1980-84 inclusive, 6 patients were found to have cerebral metastases. Intrathecal methotrexate and combination chemotherapy were started in all cases, with monitoring of tumor growth by serial beta-HCG assays and CT scanning of brain and lung. Chemotherapy was reduced because of severe toxicity in 2 patients, one of whom received radiotherapy to the brain. Four patients (66%) have now been in remission for 2.5-6 years. Two did not respond to therapy and died. The factors involved in therapy and response are discussed.

Adult↗