ABSTRACT
INTRODUCTION: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a novel coronavirus, now widely known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has caused 3 major pandemic waves in Malaysia. We aimed to identify the warning signs as indicators that predict the progression of disease. MATERIALS AND METHODS: This is a retrospective cohort study of adult patients more than 12 years of age presenting with laboratory-confirmed COVID-19 admitted in three separate hospitals around the country. RESULTS: Of the 228 patients initially admitted with mild illness, 47 had progressed requiring oxygen. The median time from admission to deterioration was 3 days (IQR 2 - 5). Age more than ≥50years old (median age = 42.5, IQR = 28.8 - 57.0), higher temperature (mean = 37.3, IQR 36.8 - 38.0), MEWS score >3 (9, 19.1%), Neutrophil-to-lymphocyte ratio (NLR) >3.13 , (18, 38.3%) C-reactive protein (CRP) >5. (12, 27.3%), multiple zonal involvement on the chest radiography on admission (2, IQR 1-3) were more common in the deteriorated group on admission. On multivariate analysis, multiple comorbidities (HR = 7.40, 95 percent CI 2.58-21.2, p0.001), presence of persistent fever (HR = 2.88, 95 percent CI 1.15 - 7.2, p = 0.024), MEWS scoring >3 (HR of 6.72 ;95 percent CI 2.81-16.0, p0.001) were associated with progression to severe illness. CONCLUSION: In our cohort, we found that several factors were associated with the severity of COVID19. Early detection of these factors could correctly identify patients who need more intensive monitoring, and early referral for ICU care.
Subject(s)
COVID-19 , Adult , COVID-19/diagnosis , Hospitalization , Humans , Middle Aged , Pandemics , Retrospective Studies , SARS-CoV-2ABSTRACT
Dengue fever (DF) is an important public health problem, and it is now endemic in more than 100 countries worldwide. Dengue associated neurological complication is estimated to be affecting 0.5 to 6.2% of patients. Even though this is rare, neurological manifestation of DF is an increasingly recognized entity in recent years due to significant mortality and morbidity reported/seen. Reported central nervous system manifestations due to dengue include encephalitis, encephalopathy, myelitis, myositis, acute disseminated encephalomyelitis, Guillain-Barré syndrome, stroke and etc. We report here a case of acute necrotizing encephalopathy secondary to DF in a previously healthy 12-year-old girl.
Subject(s)
Dengue , Nervous System Diseases , Stroke , Child , Dengue/complications , Female , HumansABSTRACT
Dengue fever is one of the commonest tropical disease in the tropics. It can present with mild acute febrile illness to severe organ failure. Reported neurological complications of dengue include dengue encephalopathy, encephalitis, transverse myelitis and intracranial haemorrhage. Intracranial haemorrhage in dengue can present as subdural haematoma, extradural haematoma, intracerebral haemorrhage and subarachnoid haemorrhage. We report here a case of subarachnoid haemorrhage in a patient with severe dengue. Our patient was a 30-year-old man who presented with acute febrile illness. He subsequently developed plasma leakage and upper gastrointestinal bleeding. He then had reduced conscious level. Computed tomography of his brain showed subarachnoid haemorrhage. He eventually succumbed to his illness.
Subject(s)
Dengue , Encephalitis , Severe Dengue , Subarachnoid Hemorrhage , Adult , Dengue/complications , Fever , Hematoma, Subdural , Humans , Male , Severe Dengue/complications , Severe Dengue/diagnosis , Subarachnoid Hemorrhage/diagnostic imaging , Subarachnoid Hemorrhage/etiologyABSTRACT
The COVID-19 outbreak continues to evolve with the number of cases increasing in Malaysia, placing a significant burden on general practitioners (GPs) to assess and manage suspected cases. GPs must be well equipped with knowledge to set up their clinics, use Personal Protective Equipment (PPE) appropriately, adopt standard protocols on triaging and referrals, as well as educate patients about PPE. The correct use of PPE will help GPs balance between personal safety and appropriate levels of public concern.
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Tuberculosis is a nimble chameleon. It can manifest itself in various ways with atypical clinical and radiographic findings. In this report we discuss the importance of radiographic findings (nodular or mass-like forms) requiring a correlation with microbiological and histopathological results to differentiate lung cancer from TB.
Subject(s)
Lung Neoplasms/diagnosis , Lung/diagnostic imaging , Mycobacterium tuberculosis/isolation & purification , Sputum/microbiology , Tuberculosis, Pulmonary/diagnosis , Aged , Biopsy , Humans , Male , Radiography, Thoracic , Tuberculosis, Pulmonary/microbiologyABSTRACT
Accurate and rapid diagnosis of tuberculous meningitis (TBM) is important for early administration of treatment. In this study, we have evaluated the diagnostic value of smear, culture, multiplex PCR and GeneXpert MTB/RIF to detect M. tuberculosis in cerebrospinal fluid (CSF) samples from patients with suspected TBM registered in Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia. Of the 55 CSF samples collected, 12 (21.8%) samples were positive by multiplex PCR, 3 (5.4%) by GeneXpert MTB/RIF and only 1 (1.8%) by smear and culture. Multiplex PCR showed higher sensitivity to detect M. tuberculosis in patients with suspected TBM and has the potential to be used as a diagnostic method.
ABSTRACT
Anti-N-Methyl-D-Aspartate receptor (NMDAR) encephalitis is an immune mediated condition with characteristic clinical presentation. We report the first case from Borneo, Sabah and the use of electroconvulsive therapy (ECT) in treating recalcitrant psychiatrist symptoms associated with this condition.
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No abstract available.
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No abstract available.
