Displaying publications 41 - 60 of 165 in total

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  1. Fulltext Fat Embolism Syndrome - A Qualitative Review of its Incidence, Presentation, Pathogenesis and Management
    Timon C, Keady C, Murphy CG
    Malays Orthop J, 2021 Mar;15(1):1-11.
    PMID: 33880141 DOI: 10.5704/MOJ.2103.001
    Fat Embolism Syndrome (FES) is a poorly defined clinical phenomenon which has been attributed to fat emboli entering the circulation. It is common, and its clinical presentation may be either subtle or dramatic and life threatening. This is a review of the history, causes, pathophysiology, presentation, diagnosis and management of FES. FES mostly occurs secondary to orthopaedic trauma; it is less frequently associated with other traumatic and atraumatic conditions. There is no single test for diagnosing FES. Diagnosis of FES is often missed due to its subclinical presentation and/or confounding injuries in more severely injured patients. FES is most frequently diagnosed using the Gurd and Wilson criteria, like its rivals it is not clinically validated. Although FES is a multi-system condition, its effects in the lung, brain, cardiovascular system and skin cause most morbidity. FES is mostly a self-limiting condition and treatment is supportive in nature. Many treatments have been trialled, most notably corticosteroids and heparin, however no validated treatment has been established.
    Matched MeSH terms: Adrenal Cortex Hormones
  2. Preadmission use of inhaled corticosteroids and risk of fatal or severe COVID-19: a meta-analysis
    Kow CS, Hasan SS
    J Asthma, 2021 Feb 08.
    PMID: 33461348 DOI: 10.1080/02770903.2021.1878531
    Objective: With emerging of observational evidence, we aimed to perform a meta-analysis to summarize the overall effect of the chronic use of inhaled corticosteroids on the clinical outcomes in patients with coronavirus disease 2019 (COVID-19). Methods:Systematic literature search in electronic databases was performed to identify observational studies that investigated the preadmission use of inhaled corticosteroids on the risk of a fatal or severe course of illness in patients with COVID-19 and reported adjusted measures of association. Adjusted odds ratios or relative risks and the corresponding 95% confidence intervals from each study were pooled to produce pooled odds ratio and 95% confidence interval. Results: The meta-analysis revealed no significant difference in the risk for the development of a fatal course of COVID-19 with preadmission use of inhaled corticosteroids in patients with COVID-19 relative to non-use of inhaled corticosteroids (pooled odds ratio=1.28; 95% confidence interval 0.73-2.26). Similarly, the meta-analysis observed no significant difference in the risk for the development of a severe course of COVID-19 with preadmission use of inhaled corticosteroids in patients with COVID-19 relative to non-use of inhaled corticosteroids (pooled odds ratio=1.45; 95% confidence interval 0.96-2.20).Conclusions: Our findings assured the safety of continued use of inhaled corticosteroids during the COVID-19 pandemic.
    Matched MeSH terms: Adrenal Cortex Hormones
  3. Fulltext Optic neuritis in a child with biotinidase deficiency: case report and literature review
    Hayati AA, Wan-Hitam WH, Cheong MT, Yunus R, Shatriah I
    Clin Ophthalmol, 2012;6:389-95.
    PMID: 22457589 DOI: 10.2147/OPTH.S29048
    Optic atrophy has often been reported in children with biotinidase deficiency. The visual prognosis is usually poor. This report is of a 6-year-old boy with an early onset of biotinidase deficiency who presented with acute profound visual loss in both eyes. Fundoscopy revealed swollen discs in both eyes, and the imaging was consistent with bilateral optic neuritis. He was treated with systemic corticosteroid, and commenced on oral biotin. The final visual outcome was promising.
    Matched MeSH terms: Adrenal Cortex Hormones
  4. Fulltext Bilateral idiopathic optic perineuritis in a young Malay woman: A case report
    Ayesha Mohd Zain, Umi Kalthum Md Noh, Mushawiahti Mustapha, Norshamsiah Md. Din, Bastion, Mae Lynn Catherine
    Neurology Asia, 2015;20(4):407-409.
    MyJurnal
    A 28-year-old Malay woman presented with severe loss of vision in both eyes associated with periocular pain on eye movement. She was completely blind at presentation and examination showed optic discs
    swelling. Optic nerve imaging showed ‘doughnut sign’, characteristic of optic perineuritis. Steroid was
    given over six months. Visual function improved gradually and was maintained at one year follow-up.
    This case highlights the importance of differentiation between optic neuritis and optic perineuritis as
    visual recovery depends on prolonged management with corticosteroid in optic perineuritis.
    Matched MeSH terms: Adrenal Cortex Hormones
  5. Fulltext Two cases of retinal vasculitis in ocular tuberculosis involving different parts of the vascular system
    Kok, Howe Sen, Tara, Mary Georg, Mae-Lynn, Catherine Bastion, Muhaya Hj Mohamad
    Medicine & Health, 2006;1(1):91-93.
    MyJurnal
    Two case reports of retinal vasculitis in presumptive ocular tuberculosis are presented. Case 1 is a 26-year-old Malay woman who had phlebitis with choroidal lesions and case 2 is a 27 year old Malay woman who had occlusive arteritis. Both subjects had positive Mantoux tests with negative systemic screen. Both responded clinically to anti-tuberculous therapy within days of commencing therapy. There was however concurrent increase in vitritis which decreased following anti-inflammatory doses of oral corticosteroids. These two cases represent a rare mode of presentation of ocular tuberculosis for which a high index of suspicion is needed. Multidrug anti-tuberculous therapy should be combined with oral corticosteroids for effective treatment.
    Matched MeSH terms: Adrenal Cortex Hormones
  6. Fulltext Ultrasound Guided Nerve Root Injection in Patients with Cervical Spondylytic Radicular Pain
    Choong, L.T.
    Malays Orthop J, 2009;3(1):68-71.
    MyJurnal
    Selective cervical nerve root injection using a mixture of corticosteroid and lignocaine is a treatment option for managing cervical radiculopathic pain. The procedure is usually performed under image guided fluoroscopy or Computerized Tomograhy. Ultrasound-guided cervical nerve root block does not expose the patients and personnel to radiation. During injection, the fluid is mostly visualized in a real-time fashion. This retrospective study reviewed the effectiveness of ultrasound in guiding cervical peri-radicular injection for pain relief in patients with recalcitrant cervical radiculopathy. There were no complications reported in this series.
    Matched MeSH terms: Adrenal Cortex Hormones
  7. Paediatric use of IV magnesium sulphate in severe asthma exacerbation: Report of a case and review of literature
    Davendralingam Sinniah
    International e-Journal of Science, Medicine & Education, 2014;8(3):45-48.
    MyJurnal
    Nebulization with B-agonist and administration of systemic corticosteroids are standard treatments for severe asthma exacerbations, but corticosteroids take several hours to become effective. IV magnesium sulphate (MgSO4) acts faster and has both antiinflammatory and bronchodilating properties. It appears to have played a pivotal role in the successful management of a child with severe asthma exacerbation and atelectasis unresponsive to conventional therapy. A literature review reveals that the results of IV MgSO4 are much greater in children than in adults, and can avoid the need to hospitalize 25% of children presenting with severe asthma. Magnesium sulphate appears safe to use.
    Matched MeSH terms: Adrenal Cortex Hormones
  8. Onset of labour
    Chong HL, Ong HC, Ang LT
    Med J Malaysia, 1974 Sep;29(1):44-53.
    PMID: 4282630
    Matched MeSH terms: Adrenal Cortex/embryology; Adrenal Cortex Hormones/physiology
  9. Fulltext Aseptic abscess syndrome associated with traveler's diarrhea after a trip to Malaysia
    Panos Z, Giannopoulos G, Papangeli E, Antalis E, Pavli A, Spathis A, et al.
    IDCases, 2016;6:23-5.
    PMID: 27672562 DOI: 10.1016/j.idcr.2016.09.001
    The first, to our knowledge, case of the aseptic abscesses syndrome as a complication of traveler's diarrhea after a trip to Malaysia is presented. The patient failed to respond to several antimicrobials. The diagnosis was histologically confirmed and the patient only responded to immunomodulatory therapy with corticosteroids and methotrexate. Travel physicians should be aware of this entity reviewed herein in the context of traveler's diarrhea.
    Matched MeSH terms: Adrenal Cortex Hormones
  10. Fulltext Simultaneous Bilateral Optic Neuritis Following Human Papillomavirus Vaccination in a Young Child
    Michael NDB, Tuan Jaffar TN, Hussein A, Wan Hitam WH
    Cureus, 2018 Sep 24;10(9):e3352.
    PMID: 30510863 DOI: 10.7759/cureus.3352
    Vaccination-induced optic neuritis is not common. The development of optic neuritis following various vaccinations have been reported, suggesting a possible association between optic neuritis and vaccination. Of those reported cases, influenza vaccines have been the most common. Although rare, those patients who developed optic neuritis following HPV vaccination also presented with other central nervous system (CNS) demyelinating syndromes, especially following a booster dose. We present a rare case of simultaneous isolated bilateral optic neuritis following the first dose of an HPV vaccination in a young child. She received treatment with a systemic corticosteroid that resulted in a good clinical outcome without developing any demyelinating disease.
    Matched MeSH terms: Adrenal Cortex Hormones
  11. Fulltext Lichen Striatus with Nail Involvement in a 6-Year-Old Boy
    Leung AKC, Leong KF, Barankin B
    Case Rep Pediatr, 2020;2020:1494760.
    PMID: 32047689 DOI: 10.1155/2020/1494760
    We describe a 6-year-old boy with an asymptomatic linear eruption on the left index finger with mild erythema of the proximal nail fold, nail dystrophy, and subungual hyperkeratosis of the nail. A diagnosis of nail lichen striatus was made. The child was successfully treated with a topical corticosteroid. Because of its rarity, nail lichen striatus is often under-recognized. Physicians should be familiar with the nail involvement in individuals with lichen striatus so that an accurate diagnosis can be made and unnecessary investigations and treatment avoided.
    Matched MeSH terms: Adrenal Cortex Hormones
  12. Fulltext Early Recovery of Sympathetic Ophthalmia with Hearing Loss in a Young Man
    Chew-Ean T, Othman K, Alexander SM, Shatriah I
    Cureus, 2017 Nov 02;9(11):e1814.
    PMID: 29308342 DOI: 10.7759/cureus.1814
    Hearing loss is rarely associated with sympathetic ophthalmia. We describe a young man who presented with sympathetic ophthalmia and concurrent hearing loss one month post globe rupture. The presentation was very subtle and atypical. However, the patient recovered fully after two weeks of prompt oral corticosteroid therapy which resulted in good visual and hearing outcomes. This patient demonstrated that the acute phase of sympathetic ophthalmia is reversible with early recognition of features, timely diagnosis, and rapid initiation of corticosteroid therapy.
    Matched MeSH terms: Adrenal Cortex Hormones
  13. Fulltext A Case of Retroperitoneal Liposarcoma Mimicking an Adrenocortical Carcinoma
    Kang W, Singarayar C, Wahab NA, Sukor N, Kamaruddin NA
    J ASEAN Fed Endocr Soc, 2019;34(1):95-98.
    PMID: 33442143 DOI: 10.15605/jafes.034.01.15
    An adrenal mass can be a diagnostic challenge as it is not easy to differentiate the adrenal glands from other adrenal pseudotumours with only radio-imaging. We report a 28-year-old patient who was diagnosed radiologically as an adrenal cortical carcinoma after he presented with abdominal pain and fullness. Biochemically, he demonstrated secondary hyperaldosteronism. Intra-operatively there was a huge mass, inferior to a normal right adrenal, which was histopathologically proven to be a dedifferentiated liposarcoma.
    Matched MeSH terms: Adrenal Cortex Neoplasms
  14. Fulltext Global utilization of low-dose corticosteroids in severe sepsis and septic shock: a report from the PROGRESS registry
    Beale R, Janes JM, Brunkhorst FM, Dobb G, Levy MM, Martin GS, et al.
    Crit Care, 2010;14(3):R102.
    PMID: 20525247 DOI: 10.1186/cc9044
    INTRODUCTION: The benefits and use of low-dose corticosteroids (LDCs) in severe sepsis and septic shock remain controversial. Surviving sepsis campaign guidelines suggest LDC use for septic shock patients poorly responsive to fluid resuscitation and vasopressor therapy. Their use is suspected to be wide-spread, but paucity of data regarding global practice exists. The purpose of this study was to compare baseline characteristics and clinical outcomes of patients treated or not treated with LDC from the international PROGRESS (PROmoting Global Research Excellence in Severe Sepsis) cohort study of severe sepsis.

    METHODS: Patients enrolled in the PROGRESS registry were evaluated for use of vasopressor and LDC (equivalent or lesser potency to hydrocortisone 50 mg six-hourly plus 50 microg 9-alpha-fludrocortisone) for treatment of severe sepsis at any time in intensive care units (ICUs). Baseline characteristics and hospital mortality were analyzed, and logistic regression techniques used to develop propensity score and outcome models adjusted for baseline imbalances between groups.

    RESULTS: A total of 8,968 patients with severe sepsis and sufficient data for analysis were studied. A total of 79.8% (7,160/8,968) of patients received vasopressors, and 34.0% (3,051/8,968) of patients received LDC. Regional use of LDC was highest in Europe (51.1%) and lowest in Asia (21.6%). Country use was highest in Brazil (62.9%) and lowest in Malaysia (9.0%). A total of 14.2% of patients on LDC were not receiving any vasopressor therapy. LDC patients were older, had more co-morbidities and higher disease severity scores. Patients receiving LDC spent longer in ICU than patients who did not (median of 12 versus 8 days; P <0.001). Overall hospital mortality rates were greater in the LDC than in the non-LDC group (58.0% versus 43.0%; P <0.001). After adjusting for baseline imbalances, in all mortality models (with vasopressor use), a consistent association remained between LDC and hospital mortality (odds ratios varying from 1.30 to 1.47).

    CONCLUSIONS: Widespread use of LDC for the treatment of severe sepsis with significant regional and country variation exists. In this study, 14.2% of patients received LDC despite the absence of evidence of shock. Hospital mortality was higher in the LDC group and remained higher after adjustment for key determinates of mortality.

    Matched MeSH terms: Adrenal Cortex Hormones/administration & dosage*; Adrenal Cortex Hormones/pharmacology; Adrenal Cortex Hormones/therapeutic use*
  15. A unilateral optic perineuritis in a teenager - A case report
    Ameilia A, Shatriah I, Wan-Hitam WH, Yunus R
    Brain Dev, 2015 Jun;37(6):635-7.
    PMID: 25457086 DOI: 10.1016/j.braindev.2014.09.011
    Optic perineuritis is an uncommon inflammatory disorder that involves optic nerve sheath. Numerous case reports have been published on optic perineuritis in adults, the majority of whom had bilateral presentation. There are limited data on optic perineuritis occurring in pediatric patients. We report a teenager who presented with a unilateral sign that mimicked the presentation of optic neuritis. The orbit and brain magnetic resonance imaging confirmed features of unilateral optic perineuritis. She was treated with a high dose of corticosteroids for 2weeks, and her final visual outcome was satisfactory. No signs of relapse were noted during follow-up visits.
    Matched MeSH terms: Adrenal Cortex Hormones/therapeutic use
  16. Evaluation of medicinal interventions for the management of oral submucous fibrosis: a systematic review of the literature
    Awan KH, Patil S, Habib SR, Pejcic A, Zain RB
    J Contemp Dent Pract, 2014 Nov 1;15(6):812-7.
    PMID: 25825114
    Oral submucous fibrosis is a chronic, progressive scarring disease associated with both significant morbidity including pain and limited mouth opening and an increased risk for malignancy. This systematic review evaluated the different medicinal (i.e. nonsurgical) interventions available for the management of oral submucous fibrosis. An automated literature searches of online databases from January 1960 to December 2013 were performed and only studies with high level of evidence based on the guidelines of the Oxford Centre for evidence-based medicine were selected. Thirteen studies (3 randomized controlled trials and 10 clinical trials/controlled clinical trials) were included and drugs like steroids, hyaluronidase, human placenta extracts, chymotrypsin and collagenase, pentoxifylline, nylidrin hydrochloride, iron and multivitamin supplements including lycopene were used. There is a clear lack of evidence on the available drug treatment for oral submucous fibrosis and further high quality randomized controlled trials are needed to evaluate the different therapeutic agents.
    Matched MeSH terms: Adrenal Cortex Hormones/therapeutic use
  17. Efficacy and safety of diphenylcyclopropenone among Chinese patients with steroid resistant and extensive alopecia areata
    Luk NM, Chiu LS, Lee KC, Chau CT, Lee VW, Chang M, et al.
    J Eur Acad Dermatol Venereol, 2013 Mar;27(3):e400-5.
    PMID: 23057682 DOI: 10.1111/jdv.12009
    BACKGROUND: Topical immunotherapy has recently been found useful in the treatment of chronic and extensive Alopecia Areata (AA).
    OBJECTIVE: To evaluate the efficacy and safety of diphenylcyclopropenone (DPCP) use among Chinese patients with steroid resistant and extensive AA in our institute.
    METHODS: The medical records of 31 Chinese patients treated with DPCP were analysed retrospectively. The efficacy, adverse effects, and relapse rate of DPCP treatment were reviewed.
    RESULTS: Thirty-one (16 male, 15 female) Chinese patients with extensive, steroid resistant Alopecia Areata and a mean age of 28.9 years (SE 10.4) were treated. The mean age of onset was 17.8 years (SE 8.8) with an average disease duration of 11.2 years (SE 7.7). Ten patients had a history of atopy and 4 had a history of thyroid disease. Nail changes were found in 14 patients and a family history of AA was found in 2 patients. Thirteen patients (41.9%) had experienced total hair loss. Two patients abandoned the treatment due to severe side effects. Of the remaining 29 patients, 4 (13.8%), 7 (24.1%), 5 (17.2%), and 13 (44.8%) achieved >90% complete response, >50-90% partial response, >10-50% minimal response, and <10% no response hair regrowth, respectively. Adverse effects included pruritus, erythema, vesiculation, scaling, cervical lymphadenopathy, dyspigmentation and urticarial reactions. Relapse occurred (>25% hair loss) in 69.23% of patients after 18 months of follow up.
    CONCLUSIONS: DPCP is an effective and tolerable treatment for Chinese patients with extensive, steroid resistant AA.
    Matched MeSH terms: Adrenal Cortex Hormones/therapeutic use
  18. Fulltext Post viral acute multifocal posterior placoid pigment epithiopathy in a teenage child
    Nga AD, Ramli N, Mimiwati Z
    Med J Malaysia, 2009 Jun;64(2):176-8.
    PMID: 20058585 MyJurnal
    We report a rare case of a young boy presenting with bilateral blurring of vision following a viral like illness. Fundus examination revealed multiple pale cream-coloured lesions scattered across the posterior pole of both eyes. Fundus fluorescein angiography showed characteristic features of early hypofluorescence and late hyperfluorescence, further confirming the diagnosis of acute posterior placoid pigment epitheliopathy (AMPPPE). He was treated with topical steroids for the accompanying mild anterior uveitis. He had a prompt visual recovery with no adverse sequelae.
    Matched MeSH terms: Adrenal Cortex Hormones/therapeutic use
  19. Fulltext Adrenal cortical carcinoma masquerading as pheochromocytoma: a case report
    Ni H, Htet A
    Ecancermedicalscience, 2012;6:277.
    PMID: 23152728 DOI: 10.3332/ecancer.2012.277
    Adrenocortical carcinoma (ACC) is a malignant tumour arising from the adrenal cortex, while pheochromocytoma is a catecholamine secreting tumour of the adrenal medulla or extra adrenal sites. Both conditions are very rare, with incidence of approximately 1-2 cases per million adults annually. Most adrenocortical tumours are functioning. ACC can be associated with clinical Cushing syndrome and virilisation due to excessive production of cortisol and androgens, respectively. However, it is rare for ACC to present clinically as pheochromocytoma. We report a case of a 28-year-old lady who presented with paroxysmal hypertension and palpitations associated with raised urinary vanillyl mandelic acid. On examination, there was postural hypotension and ballotable mass in right lumbar region with no obvious features suggestive of Cushing syndrome or virilisation. A huge right suprarenal mass with areas of necrosis and calcification was noted on the abdomen CT. A right adrenalectomy was done. The histology was consistent with ACC. There are reported cases of ACC presenting with clinical features of pheochromocytoma but limited in number, accounting for barely a dozen cases in the literature. This pseudopheochromocytoma may be due to the presence of neuroendocrine features in ACC.
    Matched MeSH terms: Adrenal Cortex; Adrenal Cortex Neoplasms
  20. Response of exhaled nitric oxide to inhaled corticosteroids in patients with stable COPD: A systematic review and meta-analysis
    Lim CS, Rani FA, Tan LE
    Clin Respir J, 2018 Jan;12(1):218-226.
    PMID: 27328740 DOI: 10.1111/crj.12518
    INTRODUCTION: To our knowledge, no meta-analysis has investigated the response of FeNO levels to corticosteroid treatment in ex-smokers with chronic obstructive pulmonary disease (COPD).

    OBJECTIVES: This meta-analysis assessed the potential role of fraction of exhaled nitric oxide (FeNO) as a biomarker for corticosteroid response in ex-smokers with stable COPD.

    METHODS: Medline, Cochrane, EMBASE, Google Scholar databases were searched until November 5, 2014 using the following terms: corticosteroid, chronic obstructive pulmonary disease, COPD, nitric oxide, NO, exhaled nitric oxide. Only randomized controlled trials (RCT) or two-arm prospective studies were included. The primary outcome measure was FeNO before and after treatment with inhaled corticosteroids (ICS) in ex-smokers with COPD. Sensitivity analysis was also performed.

    RESULTS: Five studies were included in the analysis with a total of 171 COPD patients. All five studies included 125 ex-smokers and two of these also included 46 current smokers. There was a significant decrease of FeNO in ex-smoking COPD patients following inhaled corticosteroid treatment (-7.51, 95% CI: -11.51 to -3.51; P =0.003); and in a population of subjects that included both smokers and ex-smokers (-1.99, 95% CI: -3.41 to -0.56; P =0.006).

    CONCLUSION: Our findings indicate that FeNO levels significantly decreased with corticosteroid treatment in ex-smokers with COPD. Additional studies are required to evaluate whether concurrent smoking has significant effect on FeNO response to ICS.
    Matched MeSH terms: Adrenal Cortex Hormones/administration & dosage*
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