Displaying publications 961 - 980 of 1057 in total

Abstract:
Sort:
  1. Fulltext Computed tomography perfusion of ischaemic stroke patients in a rural Malaysian tertiary referral centre
    Man K, Kareem AM, Ahmad Alias NA, Shuaib IL, Tharakan J, Abdullah JM, et al.
    Singapore Med J, 2006 Mar;47(3):194-7.
    PMID: 16518552
    Computed tomography (CT) perfusion is a new method to diagnose ischaemic stroke especially in developing countries. It identifies the area and is useful to predict the size of final infarction. The aim of this study was to assess cerebral ischaemia with CT perfusion (CTP) among patients with acute ischaemic stroke in Hospital Universiti Sains Malaysia, a tertiary referral centre in a rural setting.
    Matched MeSH terms: Tomography, X-Ray Computed
  2. Fulltext Computed tomography of focal splenic lesions in patients presenting with fever
    Joazlina ZY, Wastie ML, Ariffin N
    Singapore Med J, 2006 Jan;47(1):37-41.
    PMID: 16397719
    INTRODUCTION: There is an awareness of the increased incidence of splenic abscess in Southeast Asia giving rise to unexplained fever. This study looks at the role of computed tomography (CT) in evaluating focal splenic lesions in patients presenting with fever.
    METHODS: 37 patients presenting with fever of unknown origin underwent CT and this study retrospectively analyses the findings in these patients. 13 patients also had associated abdominal pain. Patients with conditions at high risk for splenic infection include: diabetes mellitus in ten patients, leukaemia in seven patients, human immunodeficiency virus infection in five patients, intravenous drug abuse in six patients, and steroid therapy in two patients. No risk factors could be identified in seven patients.
    RESULTS: Splenic abscess was diagnosed in 28 patients. A range of infecting organisms was isolated but the most frequent were Staphylococcus aureus (eight), tuberculosis (four), Streptococcus (four), fungal (four) and melioidosis (four). No infecting organism could be identified in ten cases though in patients with leukaemia with multiple low attenuation areas, the cause was presumed to be fungal. Six patients were diagnosed to have splenic infarcts though differentiation from splenic abscess could be difficult; these patients were treated for an abscess and all had endocarditis. Three patients were subsequently diagnosed with lymphoma. Percutaneous abscess drainage was performed in five patients and splenectomy was carried out in six patients.
    CONCLUSION: CT proved to be very useful as it not only revealed the size and extent of any splenic abnormality but it assisted with guidance for percutaneous drainage, determined the site for biopsy, and provided follow-up after treatment.
    Matched MeSH terms: Tomography, X-Ray Computed
  3. Fulltext Intracranial bleeding (ICB) as a catastrophic complication of Streptococcus gordonii infective endocarditis (IE) in an immunocompetent patient
    Pairan MS, Mohammad N, Abdul Halim S, Wan Ghazali WS
    BMJ Case Rep, 2018 Sep 10;2018.
    PMID: 30206067 DOI: 10.1136/bcr-2018-225265
    We present an interesting case of late-onset intracranial bleeding (ICB) as a complication of Streptococcus gordonii causing infective endocarditis. A previously healthy young woman was diagnosed with infective endocarditis. While she was already on treatment for 2 weeks, she had developed seizures with a localising neurological sign. An urgent non-contrasted CT brain showed massive left frontoparietal intraparenchymal bleeding. Although CT angiogram showed no evidence of active bleeding or contrast blush, massive ICB secondary to vascular complication of infective endocarditis was very likely. An urgent decompressive craniectomy with clot evacuation was done immediately to release the mass effect. She completed total 6 weeks of antibiotics and had postoperative uneventful hospital stay despite having a permanent global aphasia as a sequel of the ICB.
    Matched MeSH terms: Tomography, X-Ray Computed
  4. Fulltext Factors prognosticating the outcome of decompressive craniectomy in severe traumatic brain injury: A Malaysian experience
    Sharda P, Haspani S, Idris Z
    Asian J Neurosurg, 2014 Oct-Dec;9(4):203-12.
    PMID: 25685217 DOI: 10.4103/1793-5482.146605
    OBJECTIVE: The objective of this prospective cohort study was to analyse the characteristics of severe Traumatic Brain Injury (TBI) in a regional trauma centre Hospital Kuala Lumpur (HKL) along with its impact of various prognostic factors post Decompressive Craniectomy (DC).
    MATERIALS AND METHODS: Duration of the study was of 13 months in HKL. 110 consecutive patients undergoing DC and remained in our centre were recruited. They were then analysed categorically with standard analytical software.
    RESULTS: Age group have highest range between 12-30 category with male preponderance. Common mechanism of injury was motor vehicle accident involving motorcyclist. Univariate analysis showed statistically significant in referral area (P = 0.006). In clinical evaluation statistically significant was the motor score (P = 0.040), pupillary state (P = 0.010), blood pressure stability (P = 0.013) and evidence of Diabetes Insipidus (P < 0.001). In biochemical status the significant statistics included evidence of coagulopathy (P < 0.001), evidence of acidosis (P = 0.003) and evidence of hypoxia (P = 0.030). In Radiological sector, significant univariate analysis proved in location of the subdural clot (P < 0.010), location of the contusion (P = 0.045), site of existence of both type of clots (P = 0.031) and the evidence of edema (P = 0.041). The timing of injury was noted to be significant as well (P = 0.061). In the post operative care was, there were significance in the overall stability in intensive care (P < 0.001), the stability of blood pressure, cerebral perfusion pressure, pulse rates and oxygen saturation (all P < 0.001)seen individually, post operative ICP monitoring in the immediate (P = 0.002), within 24 hours (P < 0.001) and within 24-48 hours (P < 0.001) period, along with post operative pupillary size (P < 0.001) and motor score (P < 0.001). Post operatively, radiologically significant statistics included evidence of midline shift post operatively in the CT scan (P < 0.001). Multivariate logistic regression with stepwise likelihood ratio (LR) method concluded that hypoxia post operatively (P = 0.152), the unmaintained Cerebral Perfusion Pressure (CPP) (P = 0.007) and unstable blood pressure (BP) (P = <0.001). Poor outcome noted 10.2 times higher in post operative hypoxia [OR10.184; 95% CI: 0.424, 244.495]. Odds of having poor outcome if CPP unmaintained was 13.8 times higher [OR: 13.754; CI: 2.050, 92.301]. Highest predictor of poor outcome was the unstable BP, 32 times higher [OR 31.600; CI: 4.530, 220440].
    CONCLUSION: Our series represent both urban and rural population, noted to be the largest series in severe TBI in this region. Severe head injury accounts for significant proportion of neurosurgical admissions, resources with its impact on socio-economic concerns to a growing population like Malaysia. This study concludes that the predictors of outcome in severe TBI post DC were postoperative hypoxia, unmaintained cerebral perfusion pressure and unstable blood pressure as independent predictors of poor outcome. Key words: Decompressive craniectomy, prognostication of decompressive craniectomy, prognostication of severe head injury, prognostication of traumatic brain injury, severe head injury, severe traumatic brain injury, traumatic brain injury.
    KEYWORDS: Decompressive craniectomy; prognostication of decompressive craniectomy; prognostication of severe head injury; prognostication of traumatic brain injury; severe head injury; severe traumatic brain injury; traumatic brain injury
    Matched MeSH terms: Tomography, X-Ray Computed
  5. Endoscopic diagnostic and therapeutic management of branchial cleft fistula type III & IV: a single tertiary centre experience
    Bee-See G, Anuar NA
    Eur Arch Otorhinolaryngol, 2024 Dec;281(12):6711-6715.
    PMID: 39073435 DOI: 10.1007/s00405-024-08853-0
    INTRODUCTION: To date, recurrent neck abscesses associated with branchial anomalies are treated using a variety of techniques. Management strategies may include various imaging modalities and surgical methods. Endoscopic assessment and electrocauterization are the preferred diagnostic modalities and treatment strategies that have recently gained widespread acceptance and popularity.

    METHODOLOGY AND RESULTS: This was a retrospective review on patients' medical record from 2016 to 2023. Seven patients underwent endoscopic cauterization at our centre, a tertiary academic institution. Five of the patients (71.5%) achieved complete remission. Two patients experienced recurrence within 6 months that necessitated re-cauterization once but subsequently recovered completely. Currently, endoscopic management is the preferred approach compared to the typical open neck excision surgery as it is significantly less invasive, resulting in lesser morbidity and similar success rates. At presentation, all of them had ultrasound neck that suggestive of neck abscess. Computed tomography or magnetic resonance imaging unable to provide adequate information about the side of internal opening of fistula where only 3 out of 7 patients demonstrated tract up to the ipsilateral region of pyriform fossa.

    DISCUSSION: Management outcomes of this limited case series showed the potential benefits of endoscopic cauterization as the minimally invasive therapeutic method for recurrent neck abscesses caused by third and fourth branchial cleft fistulas but also to suggest the possibility as the first diagnostic tool prior to imaging studies.

    Matched MeSH terms: Tomography, X-Ray Computed
  6. A minimally invasive endoscopic transnasal approach to the craniovertebral junction in the paediatric population
    Tan SH, Ganesan D, Prepageran N, Waran V
    Eur Arch Otorhinolaryngol, 2014 Nov;271(11):3101-5.
    PMID: 24986428 DOI: 10.1007/s00405-014-3149-5
    Matched MeSH terms: Tomography, X-Ray Computed
  7. Complete resolution of type B aortic intramural hematoma with medical treatment
    Moorthy PS, Sakijan AS
    Asian Cardiovasc Thorac Ann, 2014 Feb;22(2):231.
    PMID: 24585805 DOI: 10.1177/0218492312468119
    Matched MeSH terms: Tomography, X-Ray Computed
  8. Fulltext Coma due to malplaced external ventricular drain
    Chai FY, Farizal F, Jegan T
    Turk Neurosurg, 2013;23(4):561-3.
    PMID: 24101284 DOI: 10.5137/1019-5149.JTN.5724-12.1
    Ventriculostomy or external ventricular drain (EVD) placement by free-hand technique has a high malplacement rate. It is a blind procedure that often requires multiple attempts and revisions. To date, no neurological complication due to EVD malplacement has been reported in the literature. In this report, we present the first case of coma induced by a malplaced EVD and the patient regained consciousness after the drain was adjusted. Our discussion focused on various techniques that can improve the accuracy of EVD insertion. EVD insertion under image guidance provides better accuracy with limited disadvantages. We hypothesized that the patient's coma was due to the mass effect and irritation of the malplaced EVD exerted onto the ventral periaqueductal grey matter and the ascending neurons from upper brainstem.
    Matched MeSH terms: Tomography, X-Ray Computed
  9. The effect of excision of the posterior arch of C1 on C1/C2 fusion using transarticular screws
    Chang KC, Samartzis D, Fuego SM, Dhatt SS, Wong YW, Cheung WY, et al.
    Bone Joint J, 2013 Jul;95-B(7):972-6.
    PMID: 23814252 DOI: 10.1302/0301-620X.95B7.30598
    Transarticular screw fixation with autograft is an established procedure for the surgical treatment of atlantoaxial instability. Removal of the posterior arch of C1 may affect the rate of fusion. This study assessed the rate of atlantoaxial fusion using transarticular screws with or without removal of the posterior arch of C1. We reviewed 30 consecutive patients who underwent atlantoaxial fusion with a minimum follow-up of two years. In 25 patients (group A) the posterior arch of C1 was not excised (group A) and in five it was (group B). Fusion was assessed on static and dynamic radiographs. In selected patients CT imaging was also used to assess fusion and the position of the screws. There were 15 men and 15 women with a mean age of 51.2 years (23 to 77) and a mean follow-up of 7.7 years (2 to 11.6). Stable union with a solid fusion or a stable fibrous union was achieved in 29 patients (97%). In Group A, 20 patients (80%) achieved a solid fusion, four (16%) a stable fibrous union and one (4%) a nonunion. In Group B, stable union was achieved in all patients, three having a solid fusion and two a stable fibrous union. There was no statistically significant difference between the status of fusion in the two groups. Complications were noted in 12 patients (40%); these were mainly related to the screws, and included malpositioning and breakage. The presence of an intact or removed posterior arch of C1 did not affect the rate of fusion in patients with atlantoaxial instability undergoing C1/C2 fusion using transarticular screws and autograft.
    Matched MeSH terms: Tomography, X-Ray Computed
  10. A giant mastoid cholesteatoma with posterior cranial extension causing mass effect and obstructive hydrocephalus
    Sabir BI, Rahmat K, Bux SI, Rajagopal NS, Looi LM, Sia SF
    Clin Neurol Neurosurg, 2013 Oct;115(10):2192-6.
    PMID: 23791432 DOI: 10.1016/j.clineuro.2013.05.023
    Matched MeSH terms: Tomography, X-Ray Computed
  11. Fulltext Bilateral atypical optic neuritis associated with tuberculosis in an immunocompromised patient
    Jaafar J, Hitam WH, Noor RA
    Asian Pac J Trop Biomed, 2012 Jul;2(7):586-8.
    PMID: 23569976 DOI: 10.1016/S2221-1691(12)60102-6
    A 27 year-old lady, presented with sudden loss of vision in the right eye for a week. It was followed by poor vision in the left eye after 3 days. It involved the whole entire visual field and was associated with pain on eye movement. She was diagnosed to have miliary tuberculosis and retroviral disease 4 months ago. She was started on anti-TB since then but defaulted highly active anti-retroviral therapy (HAART). On examination, her visual acuity was no perception of light in the right eye and 6/120 (pinhole 3/60) in the left eye. Anterior segment in both eyes was unremarkable. Funduscopy showed bilateral optic disc swelling with presence of multiple foci of choroiditis in the peripheral retina. The vitreous and retinal vessels were normal. Chest radiography was normal. CT scan of orbit and brain revealed bilateral enhancement of the optic nerve sheath that suggest the diagnosis of bilateral atypical optic neuritis. This patient was managed with infectious disease team. She was started on HAART and anti-TB treatment was continued. She completed anti-TB treatment after 9 months without any serious side effects. During follow up the visual acuity in both eyes was not improved. However, funduscopy showed resolving of disc swelling and choroiditis following treatment.
    Matched MeSH terms: Tomography, X-Ray Computed
  12. Mural nodules in multiple cavernous haemangioma
    Nair SR, Rahmat K, Alhabshi SM, Ramli N, Seong MK, Waran V
    Clin Neurol Neurosurg, 2013 Jul;115(7):1150-3.
    PMID: 23031746 DOI: 10.1016/j.clineuro.2012.09.014
    Matched MeSH terms: Tomography, X-Ray Computed
  13. Small cell neuroendocrine carcinoma of the nasal cavity and paranasal sinuses: a rare case
    Tang IP, Singh S, Krishnan G, Looi LM
    J Laryngol Otol, 2012 Dec;126(12):1284-6.
    PMID: 23084156 DOI: 10.1017/S0022215112002435
    We report a rare case of small cell neuroendocrine carcinoma of the nasal cavity and paranasal sinuses with intracranial extension, and discuss the management of this rare tumour.
    Matched MeSH terms: Tomography, X-Ray Computed
  14. Clinical clues for head injuries amongst Malaysian infants: accidental or non-accidental?
    Thalayasingam M, Veerakumarasivam A, Kulanthayan S, Khairuddin F, Cheah IG
    Injury, 2012 Dec;43(12):2083-7.
    PMID: 22424957 DOI: 10.1016/j.injury.2012.02.010
    Identifying the differences between infants with non-accidental head injuries (NAHI) and accidental head injuries (AHI) may help alert clinicians to recognize markers of abuse. A retrospective review of infants <1 year of age admitted to a tertiary referral centre in Malaysia over a two year period with a diagnosis of head injury or abnormal computed tomography head scans was conducted to identify the clinical features pointing towards a diagnosis of NAHI by comparing the socio-demographics, presenting complaints, clinical features and the extent of hospital investigations carried out. NAHI infants were more likely to be symptomatic, under a non-related caregiver's supervision, and presented with inconsistent or no known mechanism of injury. Subdural haemorrhages were more common in NAHI infants. The history, mechanism of injury, presenting signs and symptoms as well as the nature of the injuries sustained are all valuable clues as to whether a head injury sustained during infancy is likely to be accidental or not.
    Matched MeSH terms: Tomography, X-Ray Computed
  15. Fulltext Rhino-orbito-cerebral mucormycosis in an immunocompetent patient: case report and review of literature
    Shatriah I, Mohd-Amin N, Tuan-Jaafar TN, Khanna RK, Yunus R, Madhavan M
    Middle East Afr J Ophthalmol, 2012 Apr-Jun;19(2):258-61.
    PMID: 22623872 DOI: 10.4103/0974-9233.95269
    Rhino-orbito-cerebral mucormycosis is a fungal infection that can be fatal especially in immunocompromised patients. It is extremely rare in immunocompetent individuals. We describe here an immunocompetent patient who survived rhino-orbito-cerebral mucormycosis due to Saksenaea vasiformis, and provide a literature review of this rare entity.
    Matched MeSH terms: Tomography, X-Ray Computed
  16. Velopharyngeal and choanal stenosis after radiotherapy for nasopharyngeal carcinoma
    Hussein J, Tan TS, Chong AW, Narayanan P, Omar R
    Auris Nasus Larynx, 2013 Jun;40(3):323-6.
    PMID: 22652485 DOI: 10.1016/j.anl.2012.05.004
    Choanal stenosis is a well recognized late complication of radiotherapy for nasopharyngeal carcinoma. However velopharyngeal stenosis post radiotherapy for nasopharyngeal carcinoma is rare. We present here a case of bilateral choanal stenosis and velopharyngeal stenosis in a patient treated with radiotherapy for nasopharyngeal carcinoma. A 58-year-old woman presented to our otolaryngology clinic with a one year history of nasal obstruction. She was diagnosed to have nasopharyngeal carcinoma 12 years ago for which she received radiotherapy. Clinical examination revealed bilateral choanal stenosis and velopharyngeal stenosis. Treatment of choanal stenosis and velopharyngeal stenosis is challenging due to high incidence of recurrence and patients frequently require multiple procedures. The patient underwent a transnasal endoscopic excision of velopharyngeal scar tissue and widening of posterior choana using Surgitron®, mitomycin-C applied topically to the surgical wound and bilateral stenting under general anesthesia. The stents were kept for two weeks, and 3 years post operation velopharyngeal aperture and posterior choana remained patent. As illustrated in this case velopharyngeal stenosis can occur after radiotheraphy and should not be overlooked. Combine modality of transnasal endoscopic excision of velopharyngeal scar tissue, widening of choanal stenosis with Surgitron® followed by the application of mitomycin-C and stenting has been shown to be an effective option.
    Study site: ENT clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Tomography, X-Ray Computed
  17. Extensive facial and orbital infantile hemangiomas associated with high intraocular pressure
    Shatriah I, Norazizah MA, Wan-Hitam WH, Wong AR, Yunus R, Leo SW
    Pediatr Dermatol, 2013 Jan-Feb;30(1):151-4.
    PMID: 22329437 DOI: 10.1111/j.1525-1470.2011.01618.x
    High intraocular pressure is a rare ophthalmic condition associated with infantile hemangiomas that involves the orbit, eyelid, or both. Here, we describe a patient with extensive facial and orbital infantile hemangiomas associated with high intraocular pressure in the affected eye. The prompt management of this challenging condition is essential.
    Matched MeSH terms: Tomography, X-Ray Computed
  18. Ultrasonic plaque echolucency and emboli signals predict stroke in asymptomatic carotid stenosis
    Topakian R, King A, Kwon SU, Schaafsma A, Shipley M, Markus HS, et al.
    Neurology, 2011 Aug 23;77(8):751-8.
    PMID: 21849657 DOI: 10.1212/WNL.0b013e31822b00a6
    Better methods are required to identify patients with asymptomatic carotid stenosis (ACS) at risk of future stroke. Two potential markers of high risk are echolucent plaque morphology on carotid ultrasound and embolic signals (ES) in the ipsilateral middle cerebral artery on transcranial Doppler ultrasound (TCD). We explored the predictive value of a score based on these 2 measures in the prospective, observational, international multicenter Asymptomatic Carotid Emboli Study.
    Matched MeSH terms: Tomography, X-Ray Computed
  19. Fulltext A mimicry of melioidosis by Klebsiella ozaenae infection
    Ng TH, How SH, Kuan YC, Adzura, Aziz AA, Fauzi AR
    Malays J Pathol, 2009 Dec;31(2):147-50.
    PMID: 20514860 MyJurnal
    Klebsiella ozaenae is a Gram negative bacillus. It has been described as a colonizer of oral and nasopharyngeal mucosa and is a cause of atrophic rhinitis. Klebsiella ozaenae has seldom been isolated from serious infections. However, several reports have stated that Klebsiella ozaenae may cause invasive infections and even mortality. We report a 55-year-old man with Klebsiella ozaenae infection causing abscesses involving the right eye and left kidney and possibly also in the brain, lungs and prostate. The isolates were sensitive to ceftazidime, ciprofloxacin, chloramphenicol, gentamicin and sulfamethoxazole-trimethoprim but resistant to ampicillin. He responded well to 4 weeks of i.v. ceftazidime and i.v. amoxycillin-clavulanic acid. To our knowledge, such a multiorgan infection has not been reported previously for this organism.
    Matched MeSH terms: Tomography, X-Ray Computed
  20. Endogenous Cushing syndrome from an ectopic adrenocorticotropic hormone production as a rare cause of ocular hypertension
    Khaw KW, Jalaludin MY, Suhaimi H, Harun F, Subrayan V
    J AAPOS, 2010 Aug;14(4):356-7.
    PMID: 20637667 DOI: 10.1016/j.jaapos.2010.04.009
    Ocular hypertension caused by endogenous Cushing syndrome from an ectopic adrenocorticotropic hormone-producing tumor is rare. We report an 11-year-old boy who presented with intraocular pressures (IOPs) of 50 mm Hg in both eyes. Surgical resection of the tumor was performed with subsequent normalization of serum cortisol and IOP levels.
    Matched MeSH terms: Tomography, X-Ray Computed
Related Terms
Filters
Contact Us

Please provide feedback to Administrator ([email protected])

External Links