Autoimmune Haemolytic Anaemia: A cross sectional study in a Tertiary Haematological Centre (Anemia Hemolitik Autoimun: Kajian Keratan Lintang di Pusat Hemotologi Tertier) / Jurnal Sains Kesihatan Malaysia

@#Autoimmune haemolytic anaemia (AIHA) is a group of disorders wherein autoantibody causes decompensated acquired haemolysis. There has been no epidemiological study of autoimmune haemolytic anaemia (AIHA) in Malaysia. This study retrospectively analysed the epidemiology of AIHA including Evan’s Syndrome in a Tertiary Haematology Centre in Malaysia. Patients diagnosed with AIHA and Evan’s Syndrome at 18 years old and above between 1 January 1994 to 1 October 2020 at the out-patient Haematology Clinic of Hospital Raja Permaisuri Bainun, Ipoh were selected. Patients’ information was retrieved from the outpatient clinic records. A total of 71 patients were included of which predominantly female. The mean age for both genders were comparable. Ethnic stratification revealed AIHA was higher in Malays followed by Chinese and Indian. Warm AIHA was most prevalent at 40.8%, compared to cold AIHA and Evan’s Syndrome (both 23.9%), and mixed AIHA (11.3%). Primary was more common than secondary AIHA followed by Evan’s Syndrome. Approximately half of the secondary AIHA and secondary Evan’s Syndrome were due to SLE. Overall, 67.6% of patients received corticosteroid only and 28.2% combined with immunosuppressant. Individuals at higher age and females have higher risk of developing AIHA and Evan’s Syndrome. The highest prevalence was seen among the Malay ethnic. Primary warm AIHA is the most common type and majority of Evan’s syndrome are secondary to autoimmune diseases.

Subcutaneous Sarcoidosis (Darier Roussy Sarcoid): A Rare Entity of Cutaneous Sarcoidosis

Summary@#Sarcoidosis is a multisystem disease characterised by granulomatous inflammation possibly due to hyperactivation of the immune system; with unknown etiology. Subcutaneous sarcoidosis (also known as Darier Roussy sarcoid) is a rare type of specific cutaneous lesion of sarcoidosis characterised by multiple firm, asymptomatic to mildly tender, mobile, round to oval, and skin coloured nodules. Herein we report a rare case of subcutaneous sarcoidosis.

Patient's knowledge and perception towards the use of non-steroidal anti-inflammatory drugs in rheumatology clinic northern Malaysia

In Rheumatology, non-steroidal anti-inflammatory drugs [NSAIDs] has been widely prescribed and used. However, despite their clinical benefits in the management of inflammatory and degenerative joint disease, NSAIDs have considerable side effects, mostly affecting the upper gastrointestinal system, which therefore, limit their use. This study was conducted to determine the patients' knowledge and perception regarding the used of NSAIDS. A total of 120 patients who attended the rheumatology clinic Hospital, Raja Permaisuri Bainun, Malaysia, and received NSAIDs more than 3 months were interviewed irrespective of their rheumatological conditions. Patient's knowledge and perception on the side effects of NSAIDs were recorded. Fifty-four percent of the patients obtained information regarding the side effect of NSAIDs either from the rheumatologist, rheumatology staff nurse or other medical staffs [75.4%]. The remaining 45.8% were naive of such knowledge. Fifteen percent obtained the information by surfing the internet and 9.2% from printed media. Twenty-four [24.2%] patients, experienced indigestion and/or stomach discomfort attributed to NSAIDs used. Two patients [1.7%] had hematemesis and malena once. This study shows that half of the patients who attended the rheumatology clinic were unaware of the side effect of NSAIDs. Available data showed that most of the knowledgeable patients are more conscience and self-educated. This study also reveals the important roles of clinicians, trained staff nurses as well as the pharmacist in providing the guidance and knowledge of any medication taken by patients

trends of DMARDs prescribed in rheumatoid arthritis patients in Malaysia

To evaluate the trends of disease-modifying anti-rheumatic drugs [DMARDs] used in the treatment of rheumatoid arthritis [RA]. Patients who fulfilled the ACR criteria for RA from 1995 to 2006 and who attended the Rheumatology clinic at Ipoh Hospital were selected and their records were evaluated to determine the changing trends in the used of DMARDs. 128 patients with RA were identified. The most commonly prescribed DMARD as monotherapy was sulphasalazine [47.7%], followed by methotrexate [35.9%] and hydroxychloroquine. Methotrexate and sulphasalazine were the most frequently prescribed DMARDs, of which the use of methotrexate has increased 6 folds from 1997 to 2007 and the use of sulphasalazine remains around 30% to 50%. The combination of methotrexate with leflunomid has significantly increased in usage by 4 folds during the study period whilst methotrexate with sulphasalazine combination usage had slightly declined. DMARDs are still the cornerstone in the treatment of RA. Changes in the trend and aggressive use of DMARDs has been markedly influenced by the patient's awareness of early treatment, the incapacitating damage, availability of recently introduced leflunomide and the advancement of current recommended treatment protocol

Acute renal failure and hepatitis: A rare manifestation of typhoid fever - A case report

Hepatitis complicating typhoid fever has been previously reported widely. Occurrence of acute renal failure and hepatitis together is extremely rare. A case report of complicated acute renal failure and hepatitis in a typhoid patient is reported and discussed.