MyMedR

Fulltext Association between subclinical hypothyroidism and depression: an updated systematic review and meta-analysis

Loh HH, Lim LL, Yee A, Loh HS

BMC Psychiatry, 2019 01 08;19(1):12.

PMID: 30621645 DOI: 10.1186/s12888-018-2006-2

BACKGROUND: Although depression is associated with changes in the hypothalamic-pituitary-thyroid axis, its relationship with subclinical hypothyroidism (SCH) is controversial. To date, there is a lack of data on the improvement of depressive symptoms with levothyroxine therapy among individuals with coexistent SCH.

METHODS: We conducted a meta-analysis to evaluate the association between SCH and depression including 1) the prevalence of depression in SCH (with a sub-analysis of the geriatric cohort), 2) thyroid stimulating hormone (TSH) level among patients with depression and 3) the effect of levothyroxine therapy among patients with SCH and coexistent depression.

RESULTS: In a pooled analysis of 12,315 individuals, those with SCH had higher risk of depression than euthyroid controls (relative risk 2.35, 95% confidence intervals [CI], 1.84 to 3.02; p

Matched MeSH terms: Depression/diagnosis; Hypothyroidism/diagnosis

Fulltext Ophthalmia Neonatorum

Tan AK

N Engl J Med, 2019 Jan 10;380(2):e2.

PMID: 30625059 DOI: 10.1056/NEJMicm1808613

Matched MeSH terms: Ophthalmia Neonatorum/diagnosis*; Trachoma/diagnosis*

MicroRNA-based Biosensors for Early Detection of Cancers

Rezayi M, Farjami Z, Hosseini ZS, Ebrahimi N, Abouzari-Lotf E

Curr Pharm Des, 2018;24(39):4675-4680.

PMID: 30636591 DOI: 10.2174/1381612825666190111144525

Small noncoding microRNAs (miRNAs) are known as noninvasive biomarkers for early detection in various cancers. In fact, miRNAs have key roles in carcinogenicity process such as proliferation, apoptosis and metastasis. After cardiovascular disease, cancer is the second cause of death in the world with an estimated 9.6 million deaths in 2018. So, early diagnosis of cancer is critical for successful treatment. To date, several selective and sensitive laboratory-based methods have been applied for the detection of circulating miRNA, but a simple, short assay time and low-cost method such as a biosensor method as an alternative approach to monitor cancer biomarker is required. In this review, we have highlighted recent advances in biosensors for circulating miRNA detection.

Matched MeSH terms: Cardiovascular Diseases/diagnosis; Neoplasms/diagnosis*

Contrast echocardiogram in diagnosing rare type of persistent left superior vena cava

Koay HS, Anis M, Mokhtar SA

Med J Malaysia, 2018 12;73(6):413-414.

PMID: 30647217

We report a rare case of persistent left superior vena cava (PLSVC) with direct drainage into the left atrium in a 3-yearsold boy who had been electively admitted for hypospadias repair, when he was noticed to have finger clubbing and mild hypoxia but was otherwise asymptomatic. The diagnosis of PLSVC can be made without an invasive tool as direct drainage of PLSVC into the left atrium be visualised using transthoracic echocardiography (TTE) by injecting agitated saline into the left arm.

Matched MeSH terms: Diagnosis, Differential; Heart Defects, Congenital/diagnosis

A Diagnostic Dilemma of Sinonasal T Cell Lymphoma: Report of A Unique Case and Literature Review

V S, Thamby SP, Al-Hatamleh MAI, Mohamud R, Abdullah B

Gulf J Oncolog, 2019 Sep;1(31):83-89.

PMID: 31591996

BACKGROUND: Natural Killer/T-cell non-Hodgkin lymphomas are rare and aggressive disease of non-Hodgkin lymphoma characterized by angioinvasion, angiodestruction and necrosis. It has a strong association with Epstein-Barr virus (EBV) as the lymphoma cells are almost invariably infected with the clonal episomal form of EBV. Because of their rarity, it is a challenge to diagnose and treat them even to the experienced pathologists.

CASE PRESENTATION: The featured case describes a 40-year-old male who presented with symptoms suggestive for sinusitis. Further diagnostic investigation by the functional endoscopic sinus surgery (FESS) revealed a chronic sinusitis with multiple biopsies showing negative for malignancy, viral and bacterial infections and therefore undiagnosed for sinonasal NK/T-cell lymphoma. Subsequently after a month of surgery, he developed multiple lymph nodes in inguinal where biopsy revealed extranodal NK/T-cell non-Hodgkin lymphoma, high grade but in no time for treatment, he finally succumbed to the illness.

CONCLUSION: The case presented here was initially diagnosed as a chronic sinusitis, not as sinonasal NK/Tcell lymphoma which later developed into extranodal NK/T-cell lymphoma. The prognosis showed improvement for nasal lymphomas but remains poor for disseminated and extranasal lymphomas which are more aggressive with lower survival rate. It is clinically important to differentiate diseases for proper staging and monitoring as they require completely different treatment strategies.

Matched MeSH terms: Nose Neoplasms/diagnosis*; Lymphoma, Extranodal NK-T-Cell/diagnosis*

Fulltext Dental technician pneumoconiosis mimicking pulmonary tuberculosis: a case report

Tan HL, Faisal M, Soo CI, Ban AY, Manap RA, Hassan TM

BMC Pulm Med, 2016 09 07;16(1):131.

PMID: 27604085 DOI: 10.1186/s12890-016-0293-2

BACKGROUND: Dental laboratory technicians are at risk of developing occupational respiratory diseases due to exposure to various potentially toxic substances in their working environment. Since 1939, few cases of silicosis among dental technician have been reported.

CASE PRESENTATION: We illustrate a 38 year-old female, who worked in a dental laboratory for 20 years, initially treated as pulmonary tuberculosis and chronic necrotising aspergillosis without much improvement. Computed tomography guided lung biopsy and bronchoscopic transbronchial lung biopsy were performed. Lung tissue biopsies showed presence of refractile dental materials within the areas of histiocyte proliferation. The diagnosis of dental technician pneumoconiosis was obtained and our patient underwent pulmonary rehabilitation.

CONCLUSIONS: This case highlights the importance of obtaining a detailed occupational history in tuberculosis endemic area, as pulmonary tuberculosis is a great mimicker of other respiratory diseases.

Matched MeSH terms: Diagnosis, Differential; Tuberculosis, Pulmonary/diagnosis

Fulltext Accelerating action on cervical screening in lower- and middle-income countries (LMICs) post COVID-19 era

Woo YL, Gravitt P, Khor SK, Ng CW, Saville M

Prev Med, 2021 03;144:106294.

PMID: 33678225 DOI: 10.1016/j.ypmed.2020.106294

Cervical cancer remains the fourth most common cancer in women, with 85% of deaths occurring in LMICs. Despite the existence of effective vaccine and screening tools, efforts to reduce the burden of cervical cancer must be considered in the context of the social structures within the health systems of LMICs. Compounding this existing challenge is the global COVID-19 pandemic, declared in March 2020. While it is too soon to tell how health systems priorities will change as a result of COVID-19 and its impact on the cervical cancer elimination agenda, there are opportunities to strengthen cervical screening by leveraging on several trends. Many LMICs maximized the strengths of their long established community-based primary care and public health systems with expansion of surveillance systems which incorporated mobile technologies. LMICs can harness the momentum of the measures taken against COVID-19 to consolidate the efforts against cervical cancer. Self-sampling, molecular human papillomavirus (HPV) testing and digital health will shift health systems towards stronger public health and primary care networks and away from expensive hospital-based care investments. While COVID-19 will change health systems priorities in LMICs in ways that may de-prioritize cervical cancer screening, there are significant opportunities for integration into longer-term trends towards universal health coverage, self-care and digital health.

Matched MeSH terms: Uterine Cervical Neoplasms/diagnosis*; Papillomavirus Infections/diagnosis*

A case of congenital hernia of the lung and tertiary syphilis

Kiramathypathy K

Malayan Medical Journal, 1929;4:12-13.

Matched MeSH terms: Hernia/diagnosis; Lung Diseases/diagnosis

Fulltext 'A recurrent cutaneous eruption'

Devaraj NK

BMJ Case Rep, 2019 Feb 01;12(2).

PMID: 30709894 DOI: 10.1136/bcr-2018-228355

Matched MeSH terms: Shellfish Hypersensitivity/diagnosis*; Exanthema/diagnosis*

Post-dengue encephalopathy and Parkinsonism

Fong CY, Hlaing CS, Tay CG, Ong LC

Pediatr Infect Dis J, 2014 Oct;33(10):1092-4.

PMID: 24776518 DOI: 10.1097/INF.0000000000000382

Parkinsonism as a neurologic manifestation of dengue infection is rare with only 1 reported case in an adult patient. We report a case of a 6-year-old child with self-limiting post-dengue encephalopathy and Parkinsonism. This is the first reported pediatric case of post-dengue Parkinsonism and expands the neurologic manifestations associated with dengue infection in children. Clinicians should consider the possibility of post-dengue Parkinsonism in children with a history of pyrexia from endemic areas of dengue.

Matched MeSH terms: Brain Diseases/diagnosis*; Parkinsonian Disorders/diagnosis*

Magnesium deficiency: a possible cause of restless leg syndrome in haemodialysis patients

Sinniah D

Intern Med J, 2015 Apr;45(4):467-8.

PMID: 25827521 DOI: 10.1111/imj.12715

Matched MeSH terms: Magnesium Deficiency/diagnosis*; Restless Legs Syndrome/diagnosis*

Chylous mesenteric cyst in children -A case report in a 4-year-old boy

Kusuma FSP, Poerwadi P

Med J Malaysia, 2020 05;75(Suppl 1):48-50.

PMID: 32471968

Chylous mesenteric cyst is a very rare case, with some vague clinical findings, and it is hard to establish the diagnosis before surgery. The most common complaints post-surgery are abdominal pain and abdominal distention. We report a case of chylous mesenteric cyst in a 4-year-old boy with chief complaint of a lump in the abdomen. Preoperative abdominal ultrasound study could not identify the origin of the mass, and suspected it as a tuberculous peritonitis. A repeat ultrasound examination revealed a multicystic mass, suspected as lymphangioma. From the exploratory laparotomy, we noted a giant mesenterial cyst (20cm in diameter) containing chylous fluid within the ileal mesentery situated 30cm from the ileocaecal junction and made an effect of diminution of the bowel lumen above it, resection and end to end anastomoses was done. Histopathology examination confirmed it as a giant mesenteric cystic lymphangioma.

Matched MeSH terms: Diagnosis, Differential; Abdominal Pain/diagnosis

Screening for phaeochromocytoma in patients with acute cerebrovascular disease: Is it necessary?

Mohamed Zainuddin N, Sthaneshwar P, Ratnasingam J

Malays J Pathol, 2020 Aug;42(2):203-207.

PMID: 32860372

INTRODUCTION: Phaeochromocytoma may present with uncontrolled hypertension leading to haemorrhagic stroke (HS), ischaemic stroke (IS) and transient ischaemic attack (TIA). False elevation in the levels of CATS/ METS has been reported in acute cerebrovascular disease. Our aim was to analyse the frequency and pattern of elevations of CATS/METS in patients with acute cerebrovascular disease and to determine associated factors.

MATERIALS AND METHODS: This is a retrospective study of 112 samples of CATS/ METS received by the laboratory over a two-year period, from patients with acute cerebrovascular disease. CATS/METS were measured using LC/MS/MS method. Clinical details and CATS/METS level were obtained from the database. Mann-Whitney U test and Kruskal Wallis test were used for statistical analysis. These statistical analyses were performed using SPSS v.20.0 (IBM Corp., Armonk, NY, USA).

RESULTS: Of the 112 patients, 39% had HS, 54% had IS and 7% had TIA. A total of 29% of patients had elevated CATS/ METS. Elevated levels of CATS/METS were noted in 41% and 25% of HS and IS patients, respectively (p=0.53). Median norepinephrine, epinephrine and metanephrine levels in HS were significantly higher than IS (p< 0.05). Systolic blood pressure was higher in those who had elevated CATS/ METS (p=0.04). Only for two patients with elevated CATS/METS repeat testing was performed. Age, diastolic blood pressure and the time of sample collection in relation to the presentation, for CATS/METS were not significantly different between groups that had elevated levels of CATS/ METS versus those who did not.

CONCLUSION: We noted that CATS/METS were elevated in one-third of patients, especially in patients with high systolic blood pressure. Increase in CATS/METS should be appropriately followed up with repeat testing. Since false elevation in CATS/METS has been reported in cerebrovascular disease, screening for phaeochromocytoma is best deferred for a month.

Matched MeSH terms: Adrenal Gland Neoplasms/diagnosis; Pheochromocytoma/diagnosis*

Hypercalcaemia: an unusual presenting feature of childhood acute lymphoblastic leukaemia

Rajagopal R, Lum SH, Jalaludin MY, Krishnan S, Abdullah WA, Ariffin H

Br J Haematol, 2013 Oct;163(2):147.

PMID: 23961807 DOI: 10.1111/bjh.12500

Matched MeSH terms: Hypercalcemia/diagnosis*; Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis*

A case report of Blastocystis infection and Steven Johnson's syndrome

Singh A, Priyadarshi K, Raj T, Banerjee T

Trop Biomed, 2019 Dec 01;36(4):987-992.

PMID: 33597468

Blastocystis species (spp.) is an emerging pathogen. There are several unsolved issues linked to this parasite ranging from its nomenclature, commensal status, standardization of laboratory diagnostic methods, genotypes and treatment. Recently, there has been an increase in reports of Blastocystis spp. from symptomatic cases which provide enough evidence of its pathogenic potential. A range of signs and symptoms, from gastro-intestinal to cutaneous manifestations have been attributed to Blastocystis infection. Few reports have established an association between intestinal infection with Blastocystis spp. and skin manifestations in form of urticaria, palmoplantar pruritus and allergy with complete resolution of cutaneous lesions with eradication of the parasite. In this report, we describe a case of Steven Johnson's syndrome (SJS) in a 6 years old girl along with infection with Blastocystis spp. marked by diarrhea and abdominal pain. Stool examination revealed the presence of all forms of the parasite with subsequent decrease in parasite burden and diarrhea over a period of time. Interestingly, the clearance of Blastocystis spp. from stool was followed by recovery from skin lesions and other symptoms. In this case, the course of SJS was clearly associated with Blastocystis infection. Though skin manifestation with Blastocystis infection has been previously reported, this is the first report of its association with SJS. This report indicates newer insights of the parasite that are less well studied.

Matched MeSH terms: Stevens-Johnson Syndrome/diagnosis*; Blastocystis Infections/diagnosis*

Sudden death due to infective endocarditis caused by Streptococcus constellatus: A case report

Zamasry MS, Hilmi Z, Mohd Yusof MYP, Razali HSA, Nawawi H, Mahmood MS

Trop Biomed, 2019 Dec 01;36(4):845-849.

PMID: 33597456

Infective endocarditis (IE) is a relatively uncommon disease, but has been challenging to diagnose over the years. With the increasing incidence, variety of causative agents and the resistance of microorganisms towards antibiotics, there is still an occurrence of sudden death due to undiagnosed IE. The most common microorganism causing IE is Staphylococcus aureus. However, there is increasing prevalence of other microorganisms causing IE. This case report highlights a case of sudden death due to IE caused by a rare pathogen, Streptococcus constellatus which belongs to the Streptococcus anginosus group (Milleri group). A study noted the crude incidence of IE in 6 world regions ranged between 1.5 and 11.6 cases per 100,000 people. To date, there has been no previous report on sudden death due to IE caused by Streptococcus constellatus in Malaysia, neither in the forensic nor clinical setting. This case report underlined the characteristics and pathological features of this microorganism. The increasing incidence and variety of causative organisms in IE are important public health issues. It is vital for future studies to examine the risk factors of IE related to Streptococcus constellatus, to enhance better understanding, insight and awareness regarding the course of this disease. This in turn may facilitate preventive measures to avoid morbidity and mortality from this condition.

Matched MeSH terms: Endocarditis, Bacterial/diagnosis*; Streptococcal Infections/diagnosis*

Fulltext Successful epilepsy surgery for tuberous sclerosis complex evaluated by stereoelectroencephalography

Fong CY, Bleasel A, Dexter MA, Lawson JA, Wong CH

Epileptic Disord, 2020 Oct 01;22(5):633-641.

PMID: 33146141 DOI: 10.1684/epd.2020.1211

Evaluating the candidacy for epilepsy surgery in patients with tuberous sclerosis can be challenging, particularly when non-invasive investigations do not show a clear epileptogenic zone. Stereoencephalography may be useful in such cases. We present a case in which the primary epileptogenic tuber was successfully identified by stereoencephalography, which resulted in seizure freedom following epilepsy surgery. [Published with video sequences].

Matched MeSH terms: Epilepsy/diagnosis; Tuberous Sclerosis/diagnosis

Fulltext Case report: two human Streptococcus suis infections in Borneo, Sabah, Malaysia

Rajahram GS, Hameed AA, Menon J, William T, Tambyah PA, Yeo TW

BMC Infect Dis, 2017 03 04;17(1):188.

PMID: 28257622 DOI: 10.1186/s12879-017-2294-z

BACKGROUND: Streptococcus Suis (S.suis) is increasingly being recognised as a potentially preventable emerging zoonotic infection in humans with a global distribution. It is a major cause of meningitis especially among those in contact with pigs and has also been associated with a toxic shock syndrome.

CASE PRESENTATIONS: We report the first two human cases from Sabah, Borneo, Malaysia which expands the global reach of this important pathogen. Here, we illustrate their epidemiological risk factors, clinical presentation and resulting sequelae of both patients.

CONCLUSION: The continued public health threat of zoonotic infections such as S.suis, highlights the need for accurate epidemiological surveillance, regulation of pig farming, slaughtering and continued advocacy of best practices for pork preparation and consumption.

Matched MeSH terms: Streptococcal Infections/diagnosis*; Zoonoses/diagnosis*

Epiploic Appendagitis: An uncommon surgical diagnosis

Michael A, Zakry Y, Hanif H

Med J Malaysia, 2017 04;72(2):128-129.

PMID: 28473679 MyJurnal

Epiploic appendagitis or appendices epiploicae, is a rare cause of abdominal pain in patients with mild signs of abdominal pathology. It mimics diverticulitis or appendicitis clinically as there are no pathognomonic features. It is a surgical diagnosis presenting with localised, sharp, acute abdominal pain, not associated with symptoms like nausea, vomiting, fever or suggestive laboratory values. With the availability of abdominal CT scans and ultrasound, it will frequently be a differential diagnosis preventing unnecessary surgery for patients. However, it may be erroneous and therefore clinical judgement is of paramount importance. This report highlights this rare presentation and identifies management guidelines.

Matched MeSH terms: Colitis/diagnosis*; Diagnosis, Differential

Cardiac arrhythmias in acute myocardial infarction

Ng WH, Goh TH, Ishak E, Ahmad Z

Med J Malaysia, 1979 Dec;34(2):131-5.

PMID: 548713

Matched MeSH terms: Arrhythmias, Cardiac/diagnosis*; Myocardial Infarction/diagnosis*

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