MyMedR

Fulltext Duodenal intussusception of Brunner's gland adenoma mimicking a pancreatic tumour

Limi L, Liew NC, Badrul RH, Faisal MJ, Daniel YP

Med J Malaysia, 2010 Dec;65(4):311-2.

PMID: 21901954

Brunner's gland adenoma is a rare benign tumour of the duodenum. It is usually asymptomatic but may occasionally present with gastrointestinal haemorrhage and obstruction. We report a 40-year old lady, presenting with upper gastrointestinal bleeding and was found to have prolapsed and intussuscepted Brunner's gland adenoma of the duodenum, which mimicked the appearance of a tumour in the head of pancreas.

Matched MeSH terms: Adenoma/diagnosis*; Diagnosis, Differential; Duodenal Neoplasms/diagnosis*; Pancreatic Neoplasms/diagnosis

Successful treatment of very large congenital infantile fibrosarcoma

Hamidah A, Reena M, Halim ARA, Ibrahim S, Eguchi M, Zarina AL, et al.

Pediatr Int, 2011 Oct;53(5):768-770.

PMID: 21955012 DOI: 10.1111/j.1442-200X.2011.03358.x

Matched MeSH terms: Diagnosis, Differential; Fibrosarcoma/diagnosis; Hemangioma/diagnosis; Soft Tissue Neoplasms/diagnosis

Non-invasive diagnosis of risk in dengue patients using bioelectrical impedance analysis and artificial neural network

Ibrahim F, Faisal T, Salim MI, Taib MN

Med Biol Eng Comput, 2010 Nov;48(11):1141-8.

PMID: 20683676 DOI: 10.1007/s11517-010-0669-z

This paper presents a new approach to diagnose and classify early risk in dengue patients using bioelectrical impedance analysis (BIA) and artificial neural network (ANN). A total of 223 healthy subjects and 207 hospitalized dengue patients were prospectively studied. The dengue risk severity criteria was determined and grouped based on three blood investigations, namely, platelet (PLT) count (less than or equal to 30,000 cells per mm(3)), hematocrit (HCT) (increase by more than or equal to 20%), and either aspartate aminotransferase (AST) level (raised by fivefold the normal upper limit) or alanine aminotransferase (ALT) level (raised by fivefold the normal upper limit). The dengue patients were classified according to their risk groups and the corresponding BIA parameters were subsequently obtained and quantified. Four parameters were used for training and testing the ANN which are day of fever, reactance, gender, and risk group's quantification. Day of fever was defined as the day of fever subsided, i.e., when the body temperature fell below 37.5°C. The blood investigation and the BIA data were taken for 5 days. The ANN was trained via the steepest descent back propagation with momentum algorithm using the log-sigmoid transfer function while the sum-squared error was used as the network's performance indicator. The best ANN architecture of 3-6-1 (3 inputs, 6 neurons in the hidden layer, and 1 output), learning rate of 0.1, momentum constant of 0.2, and iteration rate of 20,000 was pruned using a weight-eliminating method. Eliminating a weight of 0.05 enhances the dengue's prediction risk classification accuracy of 95.88% for high risk and 96.83% for low risk groups. As a result, the system is able to classify and diagnose the risk in the dengue patients with an overall prediction accuracy of 96.27%.

Matched MeSH terms: Dengue/diagnosis*; Diagnosis, Computer-Assisted/methods*; Early Diagnosis

Fulltext Esophageal ulcer in a HIV-seropositive patient co-infected by herpes simplex and cytomegalovirus

Srilatha PS, Suvarna N, Gupta A, Bhat G

Indian J Pathol Microbiol, 2011 Jan-Mar;54(1):219-20.

PMID: 21393929 DOI: 10.4103/0377-4929.77420

Matched MeSH terms: Esophageal Diseases/diagnosis*; Herpes Simplex/diagnosis*; Ulcer/diagnosis*; HIV Infections/diagnosis*

Episodic vomiting and headache in children: consider occipital epilepsy

Lope RJ, Wong SW, Wu LL

J Paediatr Child Health, 2010 Apr;46(4):204-6.

PMID: 20412414 DOI: 10.1111/j.1440-1754.2009.01662.x

Children with occipital seizures often have ictal autonomic symptoms such as pallor and vomiting and lack motor manifestations. This has lead to misdiagnosis of occipital seizures in children. The following case report highlights the clinical features of a child with occipital epilepsy misdiagnosed as having migraine. The aetiology of symptomatic occipital epilepsy will be discussed.

Matched MeSH terms: Diagnosis, Differential; Epilepsies, Partial/diagnosis*; Headache/diagnosis*; Vomiting/diagnosis*

Fulltext Bilateral epidural extension of thoracic capillary vertebral (intraosseous) hemangioma mimicking spinal meningioma

Kan CH, Saw CB, Rozaini R, Fauziah K, Ng CM, Saffari MH

Med J Malaysia, 2008 Jun;63(2):154-6.

PMID: 18942307 MyJurnal

We describe a rare case of vertebra (intraosseous) hemangioma with bilateral and symmetrical epidural extension causing cord compression in a 24-year-old woman. The epidural component was isointense to cord on both T1 and T2 sequences, and enhanced markedly and homogenously following gadolinium administration. The gradual in onset and progressive nature with the typical enhancing pattern lead the neurosurgeon to the more common diagnosis of spinal meningioma. Epidural extension of vertebral hemangiomas causing cord compression is rarely reported. Review of literatures reveal that cases that have been reported are of unilateral extension into epidural space and of cavernous type. This is the first case report of capillary vertebral (intraossous) hemangioma with bilateral extension through both intervetebral foramen into the epidural space causing myelopathy.

Matched MeSH terms: Diagnosis, Differential; Hemangioma/diagnosis; Meningioma/diagnosis; Spinal Neoplasms/diagnosis

Translating the Research Diagnostic Criteria for Temporomandibular Disorders into Malay: evaluation of content and process

Khoo SP, Yap AU, Chan YH, Bulgiba AM

J Orofac Pain, 2008;22(2):131-8.

PMID: 18548842

To develop a Malay-language version of the Axis II Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) through a formal translation/back-translation process and to summarize available data about the psychometric properties of the translated scales.

Matched MeSH terms: Depression/diagnosis; Facial Pain/diagnosis; Personality Disorders/diagnosis; Temporomandibular Joint Disorders/diagnosis*

Knowledge based system with embedded intelligent heart sound analyser for diagnosing cardiovascular disorders

Javed F, Venkatachalam PA, Hani AF

J Med Eng Technol, 2007 Sep-Oct;31(5):341-50.

PMID: 17701779 DOI: 10.1080/03091900600887876

Cardiovascular disease (CVD) is the leading cause of death worldwide, and due to the lack of early detection techniques, the incidence of CVD is increasing day by day. In order to address this limitation, a knowledge based system with embedded intelligent heart sound analyser (KBHSA) has been developed to diagnose cardiovascular disorders at early stages. The system analyses digitized heart sounds that are recorded from an electronic stethoscope using advanced digital signal processing and artificial intelligence techniques. KBHSA takes into account data including the patient's personal and past medical history, clinical examination, auscultation findings, chest x-ray and echocardiogram, and provides a list of diseases that it has diagnosed. The system can assist the general physician in making more accurate and reliable diagnosis under emergency conditions where expert cardiologists and advanced equipment are not readily available. To test the validity of the system, abnormal heart sound samples and medical data from 40 patients were recorded and analysed. The diagnoses made by the system were counter checked by four senior cardiologists in Malaysia. The results show that the findings of KBHSA coincide with those of cardiologists.

Matched MeSH terms: Cardiovascular Diseases/diagnosis; Diagnosis, Computer-Assisted/methods*; Heart Murmurs/diagnosis*

Fulltext Sino-nasal hemangiopericytoma--a rare tumor

Vikneswaran T, Gendeh BS, Tan VES, Phang KS, Saravanan K

Med J Malaysia, 2005 Oct;60(4):485-8.

PMID: 16570712

Hemangiopericytoma is a very rare angiogenic tumor. In the nasal cavity, it can be considered malignant. It occurs in various parts of the body but those in the nasal cavity account for only 5% of total cases. Less than 200 cases have been reported worldwide involving the nose and paranasal sinuses. Due to its rarity a proper line of management has not been established to tackle this tumour. This article highlights two cases of hemangiopericytoma (HPC), one in an adult and the other in a child, presenting as an intranasal mass.

Matched MeSH terms: Hemangiopericytoma/diagnosis*; Nasopharyngeal Neoplasms/diagnosis*; Nose Neoplasms/diagnosis*; Paranasal Sinus Neoplasms/diagnosis

Fulltext Mesocolic hernia: a rare cause of intestinal obstruction in childhood

Kihne M, Ramanujam TM, Sithasanan N

Med J Malaysia, 2006 Jun;61(2):251-3.

PMID: 16898325 MyJurnal

Mesocolic hernia is a rare cause of intestinal obstruction in children. The diagnosis involves a high index of suspicion and prompt intervention to prevent strangulation and a high morbidity. The embryological basis of the condition is of paramount importance to assist the eventual surgical correction.

Matched MeSH terms: Diagnosis, Differential; Hernia/diagnosis; Intestinal Obstruction/diagnosis; Peritoneal Diseases/diagnosis

Fulltext A rare case of Von Hippel Lindau disease

Abdul Ghani R, Norazmi MK, Norlaila M

Med J Malaysia, 2006 Jun;61(2):254-7.

PMID: 16898326 MyJurnal

Pheochromocytoma is a rare catecholamine-secreting tumour typically arising within the adrenal medulla. It may occur sporadically or be associated as part of a tumour syndrome including Von Hippel Lindau (VHL), Multiple Endocrine Neoplasia (MEN) 2 and Neurofibromatosis Type 1. VHL is associated with multi-organ involvement of benign and malignant tumours characterized by the presence of retinal angiomas, hemangioblastomas of the cerebellum and spinal cord, renal cell carcinomas, pheochromocytomas and other cystic lesions in the kidneys, pancreas, and epididymis. It is a rare disorder with prevalence estimated at 2-3 per 100,000. This case report describes a 37 years old Chinese gentleman who presented to our institution for further management of bilateral pheochromocytoma and retinal angioblastoma with problems of duodenal ulcer and anaemia. There was no family history of similar problems. With these features the criteria for the diagnosis of von Hippel Lindau disease was established.

Matched MeSH terms: Adrenal Gland Neoplasms/diagnosis; Diagnosis, Differential; von Hippel-Lindau Disease/diagnosis*; Pheochromocytoma/diagnosis

Fulltext Concurrent mycobacterial infection and non-Hodgkin's lymphoma at the same site in an AIDS patient

Kenali MS, Fadzilah I, Maizaton AA, Sani A

Med J Malaysia, 2004 Mar;59(1):108-11.

PMID: 15535345

A 31 years old Chinese male with acquired immunodeficiency syndrome (AIDS) presented with concurrent mycobacterial infection and a synchronous non-Hodgkin's lymphoma of the nose. The diagnoses were made over a period of two months. Treatment for the mycobacterial infection was administered but he succumbed to the disease shortly after the diagnosis of NHL was established. This was an unusual case where two pathologies occurred in the same site in a patient with AIDS.

Matched MeSH terms: Diagnosis, Differential; Mycobacterium Infections/diagnosis; Nose Neoplasms/diagnosis; Lymphoma, AIDS-Related/diagnosis

Ocular presentation of sphenoid mucocele

Prepageran N, Subramaniam KN, Krishnan GG, Raman R

Orbit, 2004 Mar;23(1):45-7.

PMID: 15513020

A sphenoid mucocele often presents late due to its deep-seated anatomical site. It has a varied presentation, due to its close relationship to the cavernous sinus and the base of the skull. It can present initially to the ophthalmologist with ocular complaints. In the present paper, the authors present two cases of sphenoid mucocele, one with an isolated third and one with an isolated sixth cranial nerve palsy.

Matched MeSH terms: Blepharoptosis/diagnosis*; Diagnosis, Differential; Mucocele/diagnosis*; Oculomotor Nerve Diseases/diagnosis*

Hypoglossal nerve tumor: A rare primary extracranial meningioma of the neck

Zulkiflee AB, Prepageran N, Rahmat O, Jayalaskhmi P, Sharizal T

Ear Nose Throat J, 2012 Nov;91(11):E26-9.

PMID: 23288802

We report a case of primary extracranial meningioma arising from the hypoglossal nerve in a 54-year-old man who presented with a 9-month history of hoarseness and progressive dysphagia. He had also noticed that his tongue was deviated to the left and, as a result, he was having difficulty pronouncing words. Examination revealed fasciculation and muscle wasting on the left side of the tongue. Other cranial nerve functions were normal. Contrast-enhanced computed tomography detected a heterogeneous mass that had arisen above the bifurcation of the left common carotid artery and had extended to near the skull base. Transcervical excision of the tumor was performed, and histopathology identified it as a meningioma of the hypoglossal nerve. The patient recovered uneventfully, and he was without recurrence at more than 2 years of follow-up. A primary extracranial meningioma is extremely rare, and its presentation may be subtle. A thorough investigation is necessary to avoid fatal compressive symptoms.

Matched MeSH terms: Cranial Nerve Neoplasms/diagnosis*; Meningeal Neoplasms/diagnosis*; Meningioma/diagnosis*; Hypoglossal Nerve Diseases/diagnosis*

Vascular tumours disguising as solid organ injuries on computed tomography: a report of two cases

Chan KY, Yoong CK, Naqiyah I, Norlia A

Nepal Med Coll J, 2004 Dec;6(2):152-3.

PMID: 16295751

We report two cases of uncommon vascular lesions (Littoral cell angioma and liver haemangioma) mimicking traumatic organ injuries. The patients' histories and clinical findings of trauma were well demonstrated. Both patients had interesting CT scan features that were suggestive of solid organ injuries. However, both conditions were subsequently found to be benign incidental lesions.

Matched MeSH terms: Abdominal Injuries/diagnosis*; Diagnosis, Differential; Hemangioma/diagnosis*; Vascular Neoplasms/diagnosis*

Intraventricular squamous papillary craniopharyngioma: report of a case with intraoperative imprint cytology

Madhavan M, P JG, Abdullah Jafri J, Idris Z

Acta Cytol., 2005 Jul-Aug;49(4):431-4.

PMID: 16124175

BACKGROUND: Squamous papillary craniopharyngioma is a distinct entity, and its cytologic features may be misleading. Because of the rarity of this tumor, this case is being reported with a note on the cytologic features.

CASE: A 56-year-old Malay man who had 1-month history of generalized lethargy was admitted for altered sensorium. On examination, he was found to have neck stiffness, bilateral papilledema and generalized atrophy of muscles, with reduced power in all limbs. Magnetic resonance imaging of the brain showed a solid mass in the third ventricle causing obstructive hydrocephalus. Intraoperative cytology of the mass diagnosed intraventricular meningioma. However, the final histopathologic examination revealed squamous papillary craniopharyngioma.

CONCLUSION: Craniopharyngioma, squamous papillary type, is a rare entity and usually occurs in adults as an intraventricular solid tumor. Awareness of this entity will aid in arriving at the correct cytologic diagnosis.

Matched MeSH terms: Craniopharyngioma/diagnosis*; Meningeal Neoplasms/diagnosis*; Meningioma/diagnosis*; Pituitary Neoplasms/diagnosis*

Fulltext Diagnostic dilemma of sacral abscess presented with seizure and altered conscious level in a patient with spinal cord injury

Chek Siang KC, Ahmad Fauzi A, Hasnan N

J Spinal Cord Med, 2017 01;40(1):113-117.

PMID: 26871508 DOI: 10.1080/10790268.2015.1133016

CONTEXT: Infection and septicaemia may clinically presented with seizure and altered conscious level. In spinal cord injury (SCI) population, they are at risk of having pressure ulcer which can be complicated further with infection and septicaemia.

FINDINGS: A 40-year-old man with complete T4 SCI and multiple clean and non-healing pressure ulcers at sacral and bilateral ischial tuberosity regions was initially admitted for negative pressure wound therapy (NPWT) dressing. He had an episode of seizure and subsequently had fluctuating altered conscious level before the diagnosis of deep-seated sacral abscess was made and managed. Prior investigations to rule out common possible sources of infections and management did not resolve the fluctuating event of altered consciousness.

CLINICAL RELEVANCE: We presented an unusual case presentation of septicemia in a patient with SCI with underlying chronic non-healing pressure ulcer. He presented with seizure and fluctuating altered conscious level. Even though a chronic non-healing ulcer appeared clinically clean, a high index of suspicion for deep seated abscess is warranted as one of the possible sources of infection, especially when treatment for other common sources of infections fails to result in clinical improvement.

Matched MeSH terms: Abscess/diagnosis*; Consciousness Disorders/diagnosis*; Diagnosis, Differential; Seizures/diagnosis*

Tissue Interleukin-17 and Interleukin-23 as Biomarkers for Orbital Granulomatosis with Polyangiitis

Isa H, Luthert P, Rose G, Verity D, Pusey C, Tomkins-Netzer O, et al.

Ophthalmology, 2015 Oct;122(10):2140-2.

PMID: 26116342 DOI: 10.1016/j.ophtha.2015.04.016

Matched MeSH terms: Orbital Diseases/diagnosis*; Sarcoidosis/diagnosis; Granulomatosis with Polyangiitis/diagnosis*; Orbital Pseudotumor/diagnosis

Fulltext Calcified vertical plate of the cricoid--a rare pitfall in the diagnosis of an oesophageal foreign body

Arasaratnam S, Abdullah BJJ, Fernandez V

Med J Malaysia, 1998 Sep;53(3):290-2.

PMID: 10968170

We present a case of rare pitfall in the diagnosis of an oesophageal foreign body due to the calcified vertical plate of the cricoid to highlight the need to be aware of this entity to avoid unnecessary morbidity.

Matched MeSH terms: Calcinosis/diagnosis*; Cartilage Diseases/diagnosis*; Diagnosis, Differential; Foreign Bodies/diagnosis*

A proposed hierarchical fuzzy inference system for the diagnosis of arthritic diseases

Lim CK, Yew KM, Ng KH, Abdullah BJ

Australas Phys Eng Sci Med, 2002 Sep;25(3):144-50.

PMID: 12416592 DOI: 10.1007/BF03178776

Development of computer-based medical inference systems is always confronted with some difficulties. In this paper, difficulties of designing an inference system for the diagnosis of arthritic diseases are described, including variations of disease manifestations under various situations and conditions. Furthermore, the need for a huge knowledge base would result in low efficiency of the inference system. We proposed a hierarchical model of the fuzzy inference system as a possible solution. With such a model, the diagnostic process is divided into two levels. The first level of the diagnosis reduces the scope of diagnosis to be processed by the second level. This will reduce the amount of input and mapping for the whole diagnostic process. Fuzzy relational theory is the core of this system and it is used in both levels to improve the accuracy.

Matched MeSH terms: Arthritis/diagnosis*; Diagnosis, Computer-Assisted/methods*; Diagnosis, Differential

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