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  1. Automatic diagnosis of epileptic seizures using entropy-based features and multimodel deep learning approaches
    Al-Qazzaz NK, Alrahhal M, Jaafer SH, Ali SHBM, Ahmad SA
    Med Eng Phys, 2024 Aug;130:104206.
    PMID: 39160030 DOI: 10.1016/j.medengphy.2024.104206
    Epilepsy is one of the most common brain diseases, characterised by repeated seizures that occur on a regular basis. During a seizure, a patient's muscles flex uncontrollably, causing a loss of mobility and balance, which can be harmful or even fatal. Developing an automatic approach for warning patients of oncoming seizures necessitates substantial research. Analyzing the electroencephalogram (EEG) output from the human brain's scalp region can help predict seizures. EEG data were analyzed to extract time domain features such as Hurst exponent (Hur), Tsallis entropy (TsEn), enhanced permutation entropy (impe), and amplitude-aware permutation entropy (AAPE). In order to automatically diagnose epileptic seizure in children from normal children, this study conducted two sessions. In the first session, the extracted features from the EEG dataset were classified using three machine learning (ML)-based models, including support vector machine (SVM), K nearest neighbor (KNN), or decision tree (DT), and in the second session, the dataset was classified using three deep learning (DL)-based recurrent neural network (RNN) classifiers in The EEG dataset was obtained from the Neurology Clinic of the Ibn Rushd Training Hospital. In this regard, extensive explanations and research from the time domain and entropy characteristics demonstrate that employing GRU, LSTM, and BiLSTM RNN deep learning classifiers on the All-time-entropy fusion feature improves the final classification results.
    Matched MeSH terms: Diagnosis, Computer-Assisted/methods; Seizures/diagnosis
  2. Fulltext About clinicopathological conference and its' practice in the School of Medical Sciences, USM
    Hassan S
    Malays J Med Sci, 2006 Jul;13(2):7-10.
    PMID: 22589598
    The clinicopathological conference, popularly known as CPC primarily relies on case method of teaching medicine. It is a teaching tool that illustrates the logical, measured consideration of a differential diagnosis used to evaluate patients. The process involves case presentation, diagnostic data, discussion of differential diagnosis, logically narrowing the list to few selected probable diagnoses and eventually reaching a final diagnosis and its brief discussion. The idea was first practiced in Boston, back in 1900 by a Harvard internist, Dr. Richard C. Cabot who practiced this as an informal discussion session in his private office. Dr. Cabot incepted this from a resident, who in turn had received the idea from a roommate, primarily a law student.
    Matched MeSH terms: Diagnosis, Differential
  3. Cryptococcocis: a rare fungal infection of the tongue
    Mohamad I, Abdullah B, Salim R, Rajet KA, Naik VR
    Southeast Asian J Trop Med Public Health, 2010 Sep;41(5):1188-91.
    PMID: 21073040
    Fungal infection in the oral cavity is not uncommon. The site involved is usually species related. Cryptococcus rarely infects the oral cavity. We report an elderly patient who presented with a central lesion on the dorsum of the tongue. Biopsy revealed a fungal infection. Special stains confirmed cryptococcus. Being a rare location for cryptococcal infection, clinical suspicion should be correlated with histopathological examination. Once confirmed, the patient should be treated with an antifungal medication.
    Matched MeSH terms: Cryptococcosis/diagnosis; Diagnosis, Differential; Tongue Diseases/diagnosis
  4. Oral histoplasmosis presenting as oral ulcer in a non-HIV patient
    Rahman MT, Bakar NH, Philip R, Shamsudin AR
    Southeast Asian J Trop Med Public Health, 2004 Jun;35(2):388-90.
    PMID: 15691142
    A 40-year-old man presented with chronic mouth ulcer for the last six months. Histopathological examination of the biopsy from the lesion confirmed a diagnosis of histoplasmosis. Although histoplasmosis commonly manifests in immunocompromized patients, like HIV, the present case was negative for HIV. Histoplasmosis is endemic in certain parts of the world and it is comparatively rare in the South Asian region, particularly Malaysia. Thirty-seven cases of histoplasmosis were reported from Malaysia (Ng and Siar, 1996), between July 1967 and October 1997. Despite the apparent rarity of the disease, clinicians and pathologists should be aware of the possibility of histoplasmosis when cases of oral ulcer are encountered.
    Matched MeSH terms: Diagnosis, Differential; Histoplasmosis/diagnosis*; Mouth Diseases/diagnosis*
  5. 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: Brain Diseases/diagnosis*; Diagnosis, Differential; Mucormycosis/diagnosis*; Orbital Diseases/diagnosis*; Rhinitis/diagnosis*; Eye Infections, Fungal/diagnosis*
  6. Fulltext Metastatic disease of the proximal femur
    Faisham WI, Zulmi W, Biswal BM
    Med J Malaysia, 2003 Mar;58(1):120-4.
    PMID: 14556337
    Since January 1999, ten patients had undergone surgical treatment for metastatic bony lesions of proximal femur at this centre. Seven of these patients were treated for complete pathological fractures, one for impending fracture and one for revision of internal fixation and loosening of hemiarthroplasty. Primary malignancies were located in breast in four cases, prostate in three and one in lung, thyroid and neurofibrosarcoma. Two patients had died within six months after surgery, four after 1 year while the remaining four were still alive. The mean duration of survival was eleven months. Nine patients had been ambulating pain free and there were no failure of reconstruction.
    Matched MeSH terms: Bone Neoplasms/diagnosis; Breast Neoplasms/diagnosis; Lung Neoplasms/diagnosis; Prostatic Neoplasms/diagnosis; Thyroid Neoplasms/diagnosis; Neurofibrosarcoma/diagnosis
  7. Fulltext Bruton's agammaglobulinaemia in a child presenting with cryptococcal empyema thoracis and periauricular pyogenic abscess
    Wahab JA, Hanifah MJ, Choo KE
    Singapore Med J, 1995 Dec;36(6):686-9.
    PMID: 8781652
    We describe here a case of cryptococcal empyema thoracis and periauricular pyogenic abscess in a child with Bruton's agammaglobulinaemia. The cryptococcal empyema thoracis was treated with intravenous amphotericin B and intravenous fluconazole for six weeks followed by oral fluconazole. The pyogenic periauricular abscess was surgically drained and treated with intravenous ceftazidime and cloxacillin for two weeks. He also received monthly intravenous immunoglobulin.
    Matched MeSH terms: Abscess/diagnosis*; Agammaglobulinemia/diagnosis*; Cryptococcosis/diagnosis*; Opportunistic Infections/diagnosis*; Otitis Externa/diagnosis*; Empyema, Pleural/diagnosis*
  8. Fulltext Severe left anterior descending artery stenosis with proximal arteriovenous malformation presenting as acute myocardial infarction
    Oteh M, Azarisman SM, Hanim NM, Noorfaizan S
    Singapore Med J, 2009 Feb;50(2):e76-8.
    PMID: 19296018
    Congenital coronary artery anomalies are rare, with an incidence of about 0.06-1.3 percent of all patients undergoing cardiac catheterisation. They are commonly asymptomatic, but potentially serious lesions may lead to myocardial ischaemia, infarction and/or sudden cardiac death. The occurrence of a concomitant stenotic lesion is exceedingly rare. We report an 80-year-old man who presented with acute anterior myocardial infarction. Coronary angiography revealed severe proximal left anterior descending (LAD) and arteriovenous malformation (AVM) from the first septal branch of the LAD. The LAD stenosis and the AVM were successfully treated with two Jomed covered stents.
    Matched MeSH terms: Arteriovenous Malformations/diagnosis*; Coronary Artery Disease/diagnosis; Coronary Vessel Anomalies/diagnosis; Diagnosis, Differential; Myocardial Infarction/diagnosis*; Coronary Stenosis/diagnosis*
  9. Fulltext Diagnostic yield of flexible bronchoscopic procedures in lung cancer patients according to tumour location
    Liam CK, Pang YK, Poosparajah S
    Singapore Med J, 2007 Jul;48(7):625-31.
    PMID: 17609823
    This study aims to determine whether the diagnostic yield of flexible bronchoscopy sampling procedures in patients with lung cancer was dependent on tumour location.
    Matched MeSH terms: Adenocarcinoma/diagnosis; Carcinoma, Non-Small-Cell Lung/diagnosis; Carcinoma, Squamous Cell/diagnosis; Cytodiagnosis/methods; Lung Neoplasms/diagnosis*; Carcinoma, Large Cell/diagnosis; Carcinoma, Small Cell/diagnosis
  10. The prognostic value of the Glasgow Coma Scale, hypoxia and computerised tomography in outcome prediction of pediatric head injury
    Ong L, Selladurai BM, Dhillon MK, Atan M, Lye MS
    Pediatr Neurosurg, 1996 Jun;24(6):285-91.
    PMID: 8988493
    The outcome of 151 children less than 15 years of age and admitted within 24 h of head injury was studied in relation to clinical and computed tomography (CT) scan features. Thirty one (20.5%) had a poor outcome (24 died, 6 were severely disabled at 6 months after injury and 1 was in a persistent vegetative state) while 120 (79.5%) had a good outcome (89 recovered well and 31 were moderately disabled). Factors associated with a poor outcome were Glasgow Coma Scale (GCS) score 24 h following injury, presence of hypoxia on admission and CT scan features of subarachnoid haemorrhage, diffuse axonal injury and brain swelling. GCS scores alone, in the absence of other factors, had limited predictive value. The prognostic value of GCS scores < 8 was enhanced two-to fourfold by the presence of hypoxia. The additional presence of the CT scan features mentioned above markedly increased the probability of a poor outcome to > 0.8, modified only by the presence of GCS scores > 12. Correct predictions were made in 90.1% of patients, indicating that it is possible to estimate the severity of a patient's injury based on a small subset of clinical and radiological criteria that are readily available.
    Matched MeSH terms: Anoxia/diagnosis*; Brain Damage, Chronic/diagnosis*; Brain Edema/diagnosis; Brain Injuries/diagnosis*; Hypoxia, Brain/diagnosis*; Subarachnoid Hemorrhage/diagnosis
  11. Late onset group b beta-hemolytic streptococcus infection in a neonate manifesting as a urinary tract infection: a rare clinical presentation
    Zurina Z, Rohani A, Neela V, Norlijah O
    Southeast Asian J Trop Med Public Health, 2012 Nov;43(6):1470-3.
    PMID: 23413711
    Group B beta-hemolytic streptococcus (GBS) sepsis is a serious bacterial infection in neonates, with significant morbidity and mortality. We report here a neonate with late onset GBS infection manifesting as a urinary tract infection (UTI) in an infant presenting with prolonged neonatal jaundice. The pathogenesis of this late onset is postulated.
    Matched MeSH terms: Diagnosis, Differential; Hyperbilirubinemia/diagnosis; Jaundice, Neonatal/diagnosis; Streptococcal Infections/diagnosis*; Urinary Tract Infections/diagnosis*; Sepsis/diagnosis*
  12. Fulltext Does lightning strike twice?
    Qi Qi C, Ajit Singh V
    BMJ Case Rep, 2012;2012.
    PMID: 22892228 DOI: 10.1136/bcr.01.2012.5518
    The authors present an interesting case under our follow-up who has had five different forms of tumours with different pathologies throughout his lifetime. He started off with hepatoma, followed by pleomorphic sarcoma of the thigh, adenocarcinoma of the prostate, meningioma and finally schwanoma. He is still alive to this date.
    Matched MeSH terms: Adenocarcinoma/diagnosis; Carcinoma, Hepatocellular/diagnosis; Liver Neoplasms/diagnosis; Meningioma/diagnosis; Neoplasms, Multiple Primary/diagnosis; Neurilemmoma/diagnosis; Prostatic Neoplasms/diagnosis; Sarcoma/diagnosis; Soft Tissue Neoplasms/diagnosis
  13. Comparison of Serum Fucose Levels in Leukoplakia and Oral Cancer Patients
    Rai NP, Anekar J, Shivaraja Shankara YM, Divakar DD, Al Kheraif AA, Ramakrishnaiah R, et al.
    Asian Pac J Cancer Prev, 2015;16(17):7497-500.
    PMID: 26625751
    BACKGROUND: Tumor markers, designated as a broad group of substances produced by malignancies, could be in the form of biochemical substances, immunological substances, cell surface changes and genetic alterations. Cancer, a disorder of cellular behavior is characterized by alteration of serum glycoproteins. L-fucose, a hexose, which is the terminal sugar in most of the plasma glycoproteins, may be useful as a tumor marker for the detection, monitoring and prognostic assessment of malignancies. The aim of the study was to ascertain the role of serum fucose as a biomarker for early detection of oral cancer and to compare serum fucose levels in healthy controls, leukoplakia and oral cancer patients.

    MATERIALS AND METHODS: The study included 60 (100.0%) subjects, who were grouped as 20 (33.3%) control subjects, 20 (33.3%) squamous cell carcinoma patients and 20 (33.3%) leukoplakia patients. Fucose estimation was done using UV-visible spectrophotometry based on the method as adopted by Winzler using cysteine reagent. The results were analyzed statistically using ANOVA with Bonferroni post hoc tests.

    RESULTS: Results showed a high significance in serum fucose in oral squamous cell carcinoma (OSCC) and leukoplakia subjects compared to normal controls. There was a gradual increase in the values noted from control to leukoplakia and to squamous cell carcinoma.

    CONCLUSIONS: Estimation of serum fucose may be a reliable marker and can be used as an effective diagnostic biomarker in oral squamous cell carcinoma patients.

    Matched MeSH terms: Carcinoma, Squamous Cell/diagnosis; Head and Neck Neoplasms/diagnosis; Leukoplakia/diagnosis; Mouth Neoplasms/diagnosis
  14. Zinc: indications in brain disorders
    Prakash A, Bharti K, Majeed AB
    Fundam Clin Pharmacol, 2015 Apr;29(2):131-49.
    PMID: 25659970 DOI: 10.1111/fcp.12110
    Zinc is the authoritative metal which is present in our body, and reactive zinc metal is crucial for neuronal signaling and is largely distributed within presynaptic vesicles. Zinc also plays an important role in synaptic function. At cellular level, zinc is a modulator of synaptic activity and neuronal plasticity in both development and adulthood. Different importers and transporters are involved in zinc homeostasis. ZnT-3 is a main transporter involved in zinc homeostasis in the brain. It has been found that alterations in brain zinc status have been implicated in a wide range of neurological disorders including impaired brain development and many neurodegenerative disorders such as Alzheimer's disease, and mood disorders including depression, Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, and prion disease. Furthermore, zinc has also been implicated in neuronal damage associated with traumatic brain injury, stroke, and seizure. Understanding the mechanisms that control brain zinc homeostasis is thus critical to the development of preventive and treatment strategies for these and other neurological disorders.
    Matched MeSH terms: Brain Diseases/diagnosis; Brain Injuries/diagnosis; Neurodegenerative Diseases/diagnosis; Stroke/diagnosis
  15. Chronic neuronopathic type of Gaucher's disease with progressive myoclonic epilepsy in the absence of visceromegaly and bone involvement
    Botross NP, Riad AA, Viswanathan S, Nordin RB, Lock HN
    Scott Med J, 2014 May;59(2):e1-6.
    PMID: 24671628 DOI: 10.1177/0036933014529868
    Gaucher's disease is a lysosomal storage disorder caused by the deficiency of glucocerebrosidase. Gaucher's disease has three clinical types: non-neuronopathic (Type 1), Acute Neuropathic (Type 2) and chronic neuronopathic (Type 3). The chronic neuronopathic (Type 3) is characterised by a variety of disease variants with onset in childhood with hepatomegaly, skeletal lesions and later slow horizontal saccades, treatment-resistant generalised tonic-clonic and myoclonic seizures, dementia, progressive spasticity, cognitive deterioration, ataxia and death in the second or third decade of life.
    Matched MeSH terms: Apraxias/diagnosis*; Ataxia/diagnosis*; Gaucher Disease/diagnosis*; Myoclonic Epilepsies, Progressive/diagnosis*
  16. Musculoskeletal symptoms and orthopaedic complications in pregnancy: pathophysiology, diagnostic approaches and modern management
    Bhardwaj A, Nagandla K
    Postgrad Med J, 2014 Aug;90(1066):450-60.
    PMID: 24904047 DOI: 10.1136/postgradmedj-2013-132377
    Low back pain is a common musculoskeletal symptom in pregnancy that can present as lumbar pain or pelvic girdle pain, with significant physical and psychosocial implications. Pelvic girdle pain is more prevalent and results in greater disability than lumbar pain. It is possible to distinguish between these two conditions from a detailed history based on the site of the pain, its intensity, disability and pain provocation tests. Management of low back pain in pregnancy is conservative, with physical exercise for lumbar pain and minimising activities that exacerbate pain, analgesics and bed rest for pelvic girdle pain, as well as avoiding abduction beyond the pain-free zone in labour. There is evidence that stabilising exercises in patients with pelvic girdle pain postpartum have a beneficial effect. Other treatment modalities that have been shown to be safe and effective include pelvic belts, transcutaneous electrical nerve stimulation, spinal manipulative therapy, acupuncture and complementary therapy with yoga. Other orthopaedic complications in pregnancy such as carpal tunnel syndrome, pubic symphysis rupture, transient osteoporosis and osteonecrosis are usually self-limiting with a satisfactory outcome. However, a lack of awareness and failure to recognise these complications can result in long-term morbidity. Knowledge of the preoperative diagnostic investigations, surgical approaches and intraoperative positioning of the mother to avoid gravid uterus compression is vital in orthopaedic emergencies such as lumbar disc herniation, cauda equina syndrome, fractures and acute compartment syndrome of the lower limb to ensure a safe maternal and fetal outcome and to prevent serious disability. Pregnancy is not contraindicated in women with pre-existing orthopaedic complications such as kyphoscoliosis and total hip arthroplasty as there is no evidence to suggest increased maternal or fetal risks.
    Matched MeSH terms: Musculoskeletal Diseases/diagnosis*; Pregnancy Complications/diagnosis*; Low Back Pain/diagnosis*; Pelvic Girdle Pain/diagnosis*
  17. Fulltext Oral hyperpigmented lesions--a case study
    Kwa SK, Gupta ED
    Aust Fam Physician, 2013 Jul;42(7):490-1.
    PMID: 23826603
    An overweight woman, aged 58 years, presented for follow up of hypertension, diabetes and dyslipidaemia. She was noted to have hyperpigmented brown macules on the inner surface of the lower lip and buccal mucosa (Figure 1). She stated that she had first noticed these lesions when aged in her 40s. Her mother died at age 58 years from gastric cancer with extensive metastases, and her brother died at age 45 years from colon cancer with spread to the liver and lungs.
    Matched MeSH terms: Diagnosis, Differential; Mouth Diseases/diagnosis*; Peutz-Jeghers Syndrome/diagnosis*; Hyperpigmentation/diagnosis*
  18. Fulltext Is it toxoplasma encephalitis, HIV encephalopathy or brain tuberculoma?
    Nimir AR, Osman E, Ibrahim IA, Saliem AM
    BMJ Case Rep, 2013;2013.
    PMID: 23580678 DOI: 10.1136/bcr-2013-008803
    A 31-year-old Malaysian man was presented with an episode of seizures by the roadside, after having been recently diagnosed as HIV positive accompanied with miliary tuberculosis. On physical examination, he was oriented to person, but not to time or place. There was no neck stiffness or papilloedema. The other systemic examination was unremarkable. Chest examination revealed crepitations at the upper zone of the right lung. After diagnosis suspicion, the case was confirmed as toxoplasma encephalitis by MRI and serological tests. Patient was treated with trimethoprim/sulfamethoxazole 480-2400 mg/day with folinic acid supplement for 60 days. Two months later, a repeat brain MRI showed resolution of the cerebral lesions.
    Matched MeSH terms: Diagnosis, Differential; AIDS Dementia Complex/diagnosis; Toxoplasmosis, Cerebral/diagnosis*; Tuberculoma, Intracranial/diagnosis
  19. Mycetoma or synovial sarcoma? A case report with review of the literature
    Jimenez AL, Salvo NL
    J Foot Ankle Surg, 2011 Sep-Oct;50(5):569-76.
    PMID: 21616683 DOI: 10.1053/j.jfas.2011.04.014
    Mycetoma, also commonly referred to as Madura foot, is statistically rare in the United States. However, it is endemic to other parts of the world. It is a pseudotumor characterized by a triad of tumefaction, draining sinuses, and grains. Two types exist, with each caused by different groups of organisms that require different treatment approaches. Therefore, the exact diagnosis and culture of the organism is vital to successful treatment outcomes. Synovial sarcoma, in contrast, is a malignancy much more commonly seen in the United States. It is characterized by a well-circumscribed, often palpable, mass that is usually well delineated on magnetic resonance imaging. It has characteristic histologic and genetic features that help distinguish it from other soft tissue masses. We present a case of a soft tissue mass diagnosed in the United States. The patient had several clinical and radiographic features of synovial sarcoma but the histologic outcome was mycetoma. The case is followed by a review of the published data.
    Matched MeSH terms: Foot Dermatoses/diagnosis; Mycetoma/diagnosis*; Soft Tissue Neoplasms/diagnosis; Sarcoma, Synovial/diagnosis
  20. Atypical (symplastic) leiomyoma of the uterus--a case report
    Siti-Aishah MA, Noriah O, Malini MN, Zainul-Rashid MR, Das S
    Clin Ter, 2011;162(5):447-50.
    PMID: 22041803
    A 30-year-old, nulliparous woman presented with a history of subfertility. On examination she was found to have uterine fibroid of 28 weeks size of gravid uterus and subsequently laporatomy myomectomy was performed. Multilobulated masses, with diameters ranging from 22 mm to 160 mm were found. Cut sections of the lobulated masses showed whitish whorled cut surface. One of the multilobulated masses had a cystic cavity, measuring 60x50x35 mm(3). Light microscopic findings of the mass with the cystic cavity showed a well-circumscribed cellular tumour composed of cells exhibiting moderate nuclear atypia which were enlarged, nuclei with prominent chromatin clumping and were distributed in areas. Some tumour cells showed large nuclear pseudoinclusions, multinucleated or multilobated tumour giant cells, smudging and few enlarged nucleoli. Mitotic activity was 4 MFs per 10 HPFs. Occasional cells with intracytoplasmic inclusions resembling rhabdoid - like features were seen. There were no atypical mitoses or tumour necroses were noted. Diagnosis of atypical leiomyoma or symplastic leiomyoma was made. Atypical or symplastic leiomyomas are rare in the region of Malaysia and the present case discusses its incidence in younger age, its morphological features along with diagnosis and clinical outcome.
    Matched MeSH terms: Diagnosis, Differential; Leiomyoma/diagnosis; Leiomyosarcoma/diagnosis; Uterine Neoplasms/diagnosis
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