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Biomedical subjects

Y Ismail

Publications and source records attributed to Y Ismail.

At least 19 recordsLinked to original sources
PubMed2002

Tuberculosis--are we missing the diagnosis?

We reviewed the 52 new cases of pulmonary tuberculosis diagnosed at Pusat Pakar Utara, Kedah in 1998. It was found that the majority of the patients had symptoms for many years. They had seen many doctors but were not diagnosed. In 40% of the patients, no investigations for tuberculosis were done and in the others tuberculosis was excluded because of negative sputum smear examination. Many had typical history and X-ray changes suggestive of tuberculosis but more sensitive investigations such as sputum culture for Mycobacterium or bronchoscopy were not performed. Cases are presented to illustrate the problems in the diagnosis.

Adult↗
PubMed1999

Human fasciolosis: a study on the relation of infection intensity and treatment to hepatobiliary affection.

Seventeen patients with established fasciolosis and ten normal controls were enrolled in the study. The Fasciola patients were divided according to infection intensity into two groups (four patients with high intensity and thirteen patients with low intensity) as assessed by egg counts coupled with ultrasonography for detection of worms in the biliary system. Aspartate and alanine aminotransferases (AST and ALT) levels were similar to those of the controls, within the accepted normal limits, before and after treatment denoting absence of hepatocellular injury. Total serum bile acids, individual bile acids: cholic acid (CA) and chenodeoxycholic acid (CDCA), gamma glutamyl transpeptidase (GGT) and serum alkaline phosphatase (SAP) were significantly higher among all patients as compared to the controls denoting a degree of cholestatic lesion in those patients. Patients with high infection intensity revealed higher parameters than those with low intensity. The difference was not significant. One month after treatment, there was a significant improvement in the cholestasis indicating parameters in all Fasciola cases compared to the pretreatment ones. This indicates the effective role of the drug on the hepatobiliary function. However, the levels were still different from the controls. In Fasciola infection, total and individual serum bile acids in conjunction with GGT and SAP evaluate the hepatobiliary status and detect any minor abnormalities especially in anicteric subjects. Studied after treatment, they can be useful indices for assessment of the improvement.

Adolescent↗
PubMed1994

The value of routine chest radiographs in acute asthma admissions.

We reviewed 116 chest radiographs done in 70 adult asthmatic patients who were admitted to the Hospital Universiti Sains Malaysia from January to December 1989. The chest radiographs were abnormal in 23% of cases. Twelve percent showed hyperinflation and 7% had pneumonia. Eight patients diagnosed clinically to have pneumonia had normal chest radiographs. Seven patients had radiographic findings of conditions which were unsuspected clinically. These included two cases of pneumonia, one case each of fibrosing alveolitis, pneumothorax, pneumomediastinum, mitral stenosis with left ventricular failure and right pleural effusion. In conclusion, we found that significant chest radiograph abnormalities in adult patients admitted for asthma were uncommon although chest radiographs were helpful in detecting complications or coincidental conditions. Chest radiograph is therefore an important investigation in adult asthmatic patients who are admitted. However, considering the cost and the risk of radiation, it should be done only in selective cases rather than as a routine procedure.

Adolescent↗
PubMed1993

Invasive sinusitis with intracranial extension caused by Curvularia lunata.

Curvularia lunata has previously been linked to localized sinus infection in immunocompetent hosts. We treated a case of pansinusitis with extensive bone destruction and intracranial extension caused by C lunata. Curvularia lunata was identified when typical fungal macroconidia appeared on culture. Numerous surgical procedures, in addition to a 12-month course of antifungal therapy consisting of 4 g of intravenous amphotericin B and an 8-month course of 400 mg of oral ketoconazole daily, were required to control the infection. This unusual case of invasive sinusitis caused by C lunata alerts the treating physician to the presence of this mold and gives an overview of diagnostic method as well as the management.

Combined Modality Therapy↗
PubMed1993

Eosinophilic pleocytosis in coccidioidal meningitis: frequency and significance.

PURPOSE: Coccidioidal meningitis (CM) is a major source of morbidity and mortality in endemic regions. The diagnosis of CM is a clinical challenge. Eosinophilic pleocytosis (EP) is an uncommon finding and present in a relatively limited number of conditions. In order to determine the frequency and the prognostic significance of EP in CM, we conducted the present study. PATIENTS AND METHODS: Retrospective chart review of all patients diagnosed as having CM between 1986 and 1991 at Kern Medical Center. All patients had clinical and cerebrospinal fluid (CSF) findings confirmatory of CM. RESULTS: Nineteen patients (70%) in the study group had EP, and of these, 8 patients (30%) met the criteria for eosinophilic meningitis (greater than or equal to 10 eosinophils/mm3). No correlation was found between EP and age, sex, race, results of complement fixation test for coccidioidal antigen in CSF or serum, peripheral eosinophilia, or outcome. CONCLUSION: The presence of EP is a frequent observation in CM. Although we did not demonstrate any prognostic correlation with EP, this finding is of major diagnostic significance and its presence should bring attention to the diagnosis of CM.

Adult↗
PubMed1993

Inhaler technique among doctors: a survey in Hospital USM.

A survey of inhaler technique using a placebo metered dose inhaler was performed among 41 house and medical officers from the Medical and Outpatient departments, Hospital USM. The majority (76%) of them had been taught at one time or another regarding inhaler technique. However, only 18 of them (48.9%) used the metered dose inhaler correctly. Medical officers currently in the Medical Department had the highest percentage of correct technique (75%); followed by medical officers in the Outpatient Department (57.1%). Among house officers, 30.8% demonstrated correct technique. The most common error was failure to hold their breath after inhaling the aerosol (53.7%).

Humans↗
PubMed1993

Extrapulmonary tuberculosis: a two-year review of cases at the General Hospital Kota Bharu.

Between January 1990 and December 1991, 100 cases of extrapulmonary tuberculosis were identified at the General Hospital Kota Bharu representing 11% of all the newly diagnosed tuberculosis. It was commonest in the third decade of life and the sites involved were the lymph nodes (34%), osteoarticular (14%), miliary (12%) and pleura (10%). Tuberculous lymphadenitis appears to be more common in females and younger patients. Fourteen patients had concurrent active pulmonary tuberculosis and in 36 others the chest X-rays showed satisfactory response to standard chemotherapy. Six patients died and six were lost to follow-up.

Adolescent↗
PubMed1993

Lung function in Malay children.

We conducted a study to measure the peak expiratory flow rate (PEFR), forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) in a group of normal Malay primary school children aged 7 to 12 years. PEFR was measured in 920 children (482 boys and 438 girls) while FVC and FEV1 were measured in 292 of them (168 boys and 124 girls). In agreement with previous studies, we found that PEFR was correlated with age and height of the subjects but FVC and FEV1 were correlated with height only. Prediction equations for all 3 lung function indices for Malay boys and girls were formulated. In comparison with the lung function values from Western and Chinese subjects, the lung function values in our subjects are lower.

Age Factors↗
PubMed1992

Plasma phospholipase A2 activity in clinical acute myocardial infarction.

1. Phospholipase A2 (PLA2) cleaves phospholipids to produce a lyso-phospholipid and free fatty acid and, in view of the biological activity of the products, PLA2 may play a role in many disease states. Lyso-phospholipids and free arachidonic acid increase in ischaemic myocardium, indicating that ischaemia activates the enzyme. 2. Plasma PLA2 activity was measured in patients with acute myocardial infarction, based on the release of labelled arachidonic acid from Escherichia coli cell membrane. Fourteen males (peak serum creatine phosphokinase (CK) above twice upper normal) were studied on day 1 (within 6 h of chest pain onset), days 2-4, and days 6-9. Normal age matched males (n = 13) were also studied. 3. Plasma PLA2 in patients with uncomplicated myocardial infarction (n = 12) was, initially, 1.14 +/- 0.10 (s.e.m.) nmol/min per mL plasma, similar to that in the normal group (1.52 +/- 0.14). On days 2-4, PLA2 activity increased to 1.94 +/- 0.18 (P less than 0.001) and this activity was correlated with the earlier peak CK level (P less than 0.02). On days 6-9, PLA2 activity was 1.49 +/- 0.13 while in two patients who developed complications and underwent open-heart surgery between the last two measurements, there were further increases to 4.22 and 4.04 nmol/min per mL. 4. The increase in plasma PLA2 in uncomplicated myocardial infarction is likely to be due to release from the damaged myocardium; whether it contributes to pathophysiology is uncertain.

Adult↗