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Two-year outcomes of methadone maintenance therapy at a clinic in Malaysia

Musa R, Abu Bakar AZ, Ali Khan U

Asia Pac J Public Health, 2012 Sep;24(5):826-32.
PMID: 21490111 DOI: 10.1177/1010539511404396

BACKGROUND: The commencement of methadone maintenance therapy (MMT) in 2005 represents a quantum leap in the management of heroin dependence in Malaysia.
OBJECTIVE: To examine the 2-year outcomes of this modality in the treatment of heroin dependence with respect to the quality of life (QOL), heroin abstinence, and rate of employment among heroin dependants attending the Tengku Ampuan Afzan Hospital (HTAA) MMT clinic.
METHOD: This was an experimental study in which the second QOL assessment was conducted 2 years after treatment initiation.
RESULTS: A total of 172 patients enrolled at the point of entry to the MMT program. The authors examined 107 patients who remained in the program 2 years later (62.6% retention rate). A paired t test demonstrated significant improvements in all 4 domains of QOL (physical, psychological, social relationships, and environment; P < .001). The most marked improvement was noted in the psychological domain.
CONCLUSION: The MMT program at HTAA is effective in improving the QOL among heroin dependants.
Study site: MMT clinic, Tengku Ampuan Afzan Hospital (HTAA), Kuantan, Pahang, Malaysia
Fulltext Primary Extraosseous Ewing Sarcoma of the Maxillary Sinus in an Adult-A Rare Case Report

Chin EW, Abu-Bakar AZ, Hitam S, Kah-Wai N, Abdullah MA

Iran J Otorhinolaryngol, 2019 Nov;31(107):391-397.
PMID: 31857985 DOI: 10.22038/ijorl.2019.35555.2173

INTRODUCTION: Ewing sarcoma (ES), which is described as diffuse endothelioma of the bone, is divided into osseous and extraosseous Ewing sarcoma (EES) mostly affecting children and adolescents. It is a rare, aggressive, and poorly differentiated small blue round cell tumor that seldom affects the head and neck regions.
CASE REPORT: Herein, we reported a 46-year-old man presenting with right nasal block, epistaxis, and epiphora from the right eye for one month. The nasal endoscopy revealed a friable mass arising from the anterior half of the right nasal cavity. Histological findings were suggestive of Ewing sarcoma. A contrast-enhanced computed tomography (CT) scan of the paranasal sinuses showed a soft tissue mass in the right anterior nasal cavity with mucosal thickening in the right maxillary sinus, without any bony erosion or distant metastasis. The patient underwent endoscopic medial maxillectomy with modified Denker's procedure, followed by a 6-cycle course of chemotherapy. He was clinically well after chemotherapy; however, the recent bone scans were suggestive of bone involvement with the tumor.
CONCLUSION: The EES of paranasal sinus in the head and neck regions is extremely rare and requires exceptional attention due to their adjacent vital structures. The ES diagnosis-related dilemma arises from the numerous differential diagnoses of small round blue cell tumors. In this regard, accurate diagnosis is important, since ES requires a multi-modality approach. Furthermore, early diagnosis and aggressive intervention are crucial to obtain good prognosis and function.
Fulltext Non-syndromic Bilateral Branchial Cyst: A Case Report

Salahuddin NA, Sanmugam SS, Abu Bakar AZ, Md Arepen SA, Mohd Bakhit NHD, Bin Muhammad Saifullah AA, et al.

Oman Med J, 2023 May;38(3):e515.
PMID: 37313249 DOI: 10.5001/omj.2023.25

Branchial cleft cysts generally occur unilaterally at the lateral aspect of the neck. Bilateral branchial cysts are rare and may have familial associations. We report a rare case of non-syndromic bilateral branchial cyst in a 23-year-old woman who presented with chronic bilateral, progressively enlarging painless neck swellings. Complete surgical excision of the bilateral cyst was done. A histopathological examination confirmed the diagnosis. Precise diagnosis with early and complete surgical excision of branchial cysts may help prevent recurrence and other complications.
Fulltext A Case Report of Kissing Carotid Arteries in the Retropharynx

Md Arepen SA, Abu Bakar AZ, Mohd Bakhit NHD, Muhammad Saifullah AAB, Salahuddin NA, Hassan NE

Iran J Otorhinolaryngol, 2022 May;34(122):181-185.
PMID: 35655544 DOI: 10.22038/IJORL.2022.58891.3033

INTRODUCTION: An aberrant carotid artery has distinct terms and may exhibit a submucosal mass in the posterior pharyngeal wall. While it is primarily asymptomatic, an extreme aberrancy doubles the risk of dissection, a cerebrovascular accident (CVA) and an injury intraoperatively.
CASE REPORT: We report a case of 'kissing carotid artery' in a 65-year-old lady who presented with a foreign body sensation felt in the throat for one week. A finding of flexible nasopharyngolaryngoscopy (FNPLS) showed a bilateral paramedian retropharyngeal pulsating mass. Radiological examinations, including Computed Tomography (CT) of the neck and an angiogram, revealed an aberrant course of bilateral carotid arteries. In view of no malignancy and vascular malformations, there was no further intervention done, and the patient was subjected to yearly surveillance.
CONCLUSION: Retropharyngeal carotid arteries are clinically significant anatomic variants. Such anomalies are potentially life-threatening and a risk factor for a severe hemorrhage during the simplest and commonly performed transoral surgeries. Thus, thorough perioperative assessment with accurate imaging techniques and studies are required to evaluate these anomalies and may avoid any disastrous complications.