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  1. Fulltext Human pentastomiasis caused by Armillifer moniliformis in Malaysian Borneo
    Latif B, Omar E, Heo CC, Othman N, Tappe D
    Am J Trop Med Hyg, 2011 Nov;85(5):878-81.
    PMID: 22049042 DOI: 10.4269/ajtmh.2011.11-0404
    We report a case of visceral pentastomiasis caused by Armillifer moniliformis in a 70-year-old aboriginal farmer from rural Malaysian Borneo. The patient complained of upper abdominal pain, jaundice, and loss of weight. Radiological investigations and subsequent histopathological examination revealed an adenocarcinoma of the pancreas with an adjacent liver nodule containing a nymph of A. moniliformis. This report constitutes the first documented human pentastomid infection in the whole of Malaysia after nearly 40 years, and it is the third description from Malaysian Borneo. Cases of human and animal pentastomiasis in Malaysia are discussed.
    Matched MeSH terms: Adenocarcinoma/diagnosis; Liver Diseases, Parasitic/diagnosis*; Pancreatic Neoplasms/diagnosis; Parasitic Diseases/diagnosis*
  2. Initial symptoms and delayed diagnosis of osteosarcoma around the knee joint
    Pan KL, Chan WH, Chia YY
    J Orthop Surg (Hong Kong), 2010 Apr;18(1):55-7.
    PMID: 20427835
    To identify initial symptoms of osteosarcoma around the knee joint.
    Matched MeSH terms: Bone Neoplasms/diagnosis*; Osteosarcoma/diagnosis*; Delayed Diagnosis*
  3. Cytologic features and differential diagnosis in chondroma of the breast: a case report
    Sivakumar S, Kaur G
    Acta Cytol., 2009 May-Jun;53(3):303-5.
    PMID: 19534271 DOI: 10.1159/000325312
    BACKGROUND: Extraskeletal (soft tissue) chondromas are rare neoplasms. They are seen most frequently in the soft tissues of hands and feet. A chondroma occurring in the breast is exceedingly uncommon. We present a case of pure chondroma of the breast in a young woman in whom fine needle aspiration (FNA) cytologic features suggested a cartilaginous neoplasm.

    CASE: A 28-year-old woman presented with a mobile lump in the left breast. Mammography showed a high-density nodule without microcalcifications. A clinical diagnosis of fibroadenoma was made. A differential diagnosis was obtained on FNA. Excisional biopsy of the lump showed the histopathologic features of chondroma. There was no recurrence or appearance of new lesion during 13 months of follow-up.

    CONCLUSION: Chondroma of the breast shows FNA cytologic features of cartilaginous tumor, but specific tumor typing may not be possible. This case highlights the difficulties that may arise in FNA diagnosis of cartilaginous tumor especially when it occurs at an unusual site. Awareness of the cytologic features combined with clinical and radiologic findings should guide the cytopathologist to make correct diagnosis of this neoplasm.
    Matched MeSH terms: Carcinoma/diagnosis; Diagnosis, Differential; Adenoma, Pleomorphic/diagnosis; Fibroadenoma/diagnosis
  4. Fulltext Early presentation of right adrenal mass, hepatoblastoma and hepatic cavernous haemangioma in Beckwith-Wiedemann Syndrome
    Teh SH, Ong GB
    Med J Malaysia, 2007 Oct;62(4):345-6.
    PMID: 18551945 MyJurnal
    Beckwith-Wiedemann Syndrome (BWS) is associated with early development of embryonal tumours usually in the first four years of life. We describe a patient who presented with a right adrenal cyst in the first month of life and hepatoblastoma in the third month of life. A cavernous haemangioma was subsequently found in the resected tumour.
    Matched MeSH terms: Adrenal Gland Neoplasms/diagnosis; Beckwith-Wiedemann Syndrome/diagnosis*; Hemangioma, Cavernous/diagnosis; Hepatoblastoma/diagnosis
  5. Fulltext Masking of central diabetes insipidus and hypogonadotrophic hypogonadism by germ cell tumour in suprasellar--pineal region
    Isa SH, Wong M, Khalid BA
    Med J Malaysia, 2006 Dec;61(5):630-2.
    PMID: 17623967
    A patient with beta hCG-secreting germ cell carcinoma of the pineal and suprasellar regions presented with hydrocephalus, Parinaud's syndrome, hypopituitarism and polyuria. Central diabetes insipidus was strongly suspected although the water deprivation test was not diagnostic. The polyuria however, responded to ADH analogue when the hypothyroidism and hypocortisolism were treated. Pubertal development was evident and serum testosterone was normal despite the low FSH/LH, suggesting hCG stimulation of Leydig cells. This case illustrates that a beta hCG-germ cell tumour of the suprasellar region causing hypopituitarism can mask the presence of central diabetes insipidus and hypogonadotrophic hypogonadism.
    Matched MeSH terms: Hypogonadism/diagnosis*; Hypopituitarism/diagnosis*; Neoplasms, Germ Cell and Embryonal/diagnosis*; Diabetes Insipidus, Neurogenic/diagnosis*
  6. Fulltext Pulmonary overinflation syndrome in an underwater logger
    Rozali A, Sulaiman A, Zin BM, Khairuddin H, Abd-Halim M, Mohd Sidik S
    Med J Malaysia, 2006 Oct;61(4):496-8.
    PMID: 17243532 MyJurnal
    Pulmonary overinflation syndrome (POIS) is a group of barotrauma-related diseases caused by the expansion of gas trapped in the lung, or over-pressurization of the lung with subsequent over-expansion and rupture of the alveolar air sacs. This group of disorders includes arterial gas embolism, tension pneumothorax, mediastinal emphysema, subcutaneous emphysema and rarely pneumopericardium. In the case of diving activities, POIS is rarely reported and is frequently related to unsafe diving techniques. We report a classical case of POIS in an underwater logger while cutting trees for logs in Tasik Kenyir, Terengganu. The patient, a 24-year-old worker, made a rapid free ascent to the surface after his breathing equipment malfunctioned while he was working underwater. He suffered from bilateral tension pneumothoraces, arterial gas embolism giving rise to multiple cerebral and cerebellar infarcts, mediastinal and subcutaneous emphysema as well as pneumopericardium. He was treated in a recompression chamber with hyperbaric oxygen therapy and discharged with residual weakness in his right leg.
    Matched MeSH terms: Decompression Sickness/diagnosis; Embolism, Air/diagnosis; Lung Diseases/diagnosis; Occupational Diseases/diagnosis
  7. Endometrial and endocervical secretion: the search for histochemical differentiation
    Nieuwenhuizen L, Khalil MK, Venkatesh N, Othman NH
    Anal. Quant. Cytol. Histol., 2006 Apr;28(2):87-96.
    PMID: 16637511
    To determine the ideal histochemical stain to differentiate between non-neoplastic and neoplastic endocervix and endometrium.
    Matched MeSH terms: Adenocarcinoma/diagnosis*; Uterine Cervical Neoplasms/diagnosis*; Diagnosis, Differential; Endometrial Neoplasms/diagnosis*
  8. Carcinosarcoma of the palate: report of a case with a diagnosis of sarcomatoid metastasis by fine needle aspiration cytology
    Jayaram G, Elsayed EM
    Acta Cytol., 2005 Sep-Oct;49(5):520-4.
    PMID: 16334029
    BACKGROUND: Carcinosarcoma (sarcomatoid carcinoma) is a rare tumor with a high predilection for the aerodigestive tract. Cytologic diagnosis of metastatic carcinosarcoma has been reported in very few cases.

    CASE: An 84-year-old woman presented with a 2-cm-diameter, right cervical lymph node that was referred for fine needle aspiration cytology (FNAC). She had received radiotherapy for a palatal squamous cell carcinoma 2 years earlier. The FNAC smears had a sarcomatoid appearance. Repeat fine needle aspiration was performed, with cytologic and immunocytochemical staining. Careful consideration of the cytologic and immunophenotypic features led to an impression of carcinosarcoma. Histologic sections of the palatal biopsy that had been previously diagnosed as squamous cell carcinoma were reviewed, and a final diagnosis of carcinosarcoma was established.

    CONCLUSION: Metastasis of rare lesions, such as carcinosarcoma may be confusing and difficult to diagnose on FNAC, especially when the cytologic sample shows a predominantly sarcomatoid component. The difficulty is compounded when the sarcomatoid component happens to have been overlooked on the initial histologic assessment. With representative cytologic sampling, immunocytochemical staining and review of the histologic material, the correct diagnosis was achieved in this case.
    Matched MeSH terms: Carcinoma, Squamous Cell/diagnosis*; Carcinosarcoma/diagnosis*; Diagnosis, Differential; Palatal Neoplasms/diagnosis*
  9. A hybrid neural network system for pattern classification tasks with missing features
    Lim CP, Leong JH, Kuan MM
    IEEE Trans Pattern Anal Mach Intell, 2005 Apr;27(4):648-53.
    PMID: 15794170
    A hybrid neural network comprising Fuzzy ARTMAP and Fuzzy C-Means Clustering is proposed for pattern classification with incomplete training and test data. Two benchmark problems and a real medical pattern classification task are employed to evaluate the effectiveness of the hybrid network. The results are analyzed and compared with those from other methods.
    Matched MeSH terms: Coronary Disease/diagnosis; Diabetes Mellitus/diagnosis; Diagnosis, Computer-Assisted/methods*
  10. Identifying the need for a multidisciplinary approach for early recognition of mucopolysaccharidosis VI (MPS VI)
    Choy YS, Bhattacharya K, Balasubramaniam S, Fietz M, Fu A, Inwood A, et al.
    Mol Genet Metab, 2015 May;115(1):41-7.
    PMID: 25892708 DOI: 10.1016/j.ymgme.2015.03.005
    Mucopolysaccharidosis VI (MPS VI, Maroteaux-Lamy syndrome) is caused by deficient activity of the enzyme, N-acetylgalactosamine-4-sulfatase, resulting in impaired degradation of the glycosaminoglycan dermatan sulfate. Patients experience a range of manifestations including joint contractures, short stature, dysostosis multiplex, coarse facial features, decreased pulmonary function, cardiac abnormalities, corneal clouding and shortened life span. Recently, clinicians from institutions in the Asia-Pacific region met to discuss the occurrence and implications of delayed diagnosis and misdiagnosis of MPS VI in the patients they have managed. Eighteen patients (44% female) were diagnosed. The most common sign presented by the patients was bone deformities in 11 patients (65%). Delays to diagnosis occurred due to the lack of or distance to diagnostic facilities for four patients (31%), alternative diagnoses for two patients (15%), and misleading symptoms experienced by two patients (15%). Several patients experienced manifestations that were subtler than would be expected and were subsequently overlooked. Several cases highlighted the unique challenges associated with diagnosing MPS VI from the perspective of different specialties and provide insights into how these patients initially present, which may help to elucidate strategies to improve the diagnosis of MPS VI.
    Matched MeSH terms: Diagnosis, Differential; Mucopolysaccharidosis VI/diagnosis*; Delayed Diagnosis/prevention & control
  11. Flat colonic adenomas in Malaysia: fact or fancy?
    Rajendra S, Kutty K, Karim N
    J Gastroenterol Hepatol, 2003 Jun;18(6):701-4.
    PMID: 12753153
    BACKGROUND: Some two-thirds of colorectal carcinomas arise from adenomatous polyps, and as such, screening by colonoscopy and polyp removal should significantly reduce colorectal cancer. This has not been the case, as evidenced by recent studies, which revealed that endoscopy failed to prevent up to 50% of all subsequent carcinomas. Flat or depressed adenomas, frequently reported from Japan but rarely elsewhere, might explain the 'missed carcinomas.' Detection of flat adenomas has not been previously reported from Malaysia.

    METHODS: In the present prospective study, 426 consecutive patients underwent colonoscopic examination between March 1997 and January 2000, for a variety of bowel symptoms. The examinations were performed by an experienced endoscopist using a standard colonoscope and methylene blue dye spraying technique. Macroscopically, flat adenomas were defined using the criteria proposed by Sawada.

    RESULTS: Twenty-nine adenomas were identified in 12 patients, of which 15 were polypoid and 14 were flat, with no depressed lesions. Eight polypoidal lesions and all the flat adenomas contained mild or moderate areas of epithelial dysplasia. Seven severely dysplastic polyps were identified. One Duke's A polypoidal cancer and two advanced carcinomas were also found. All the severely dysplastic lesions and Duke's A carcinomas were found in polyps greater than 10 mm in mean size. The flat adenomas were all less than 5 mm in size.

    CONCLUSIONS: A significant proportion of colonic adenomas in Malaysian patients appear as small flat lesions, which could easily be missed during endoscopy. Increased recognition and treatment of flat adenomas among colonoscopists is warranted.

    Matched MeSH terms: Adenoma/diagnosis; Colonic Neoplasms/diagnosis; Colonic Polyps/diagnosis; Hyperplasia/diagnosis
  12. Managing emerging diseases borne by fruit bats (flying foxes), with particular reference to henipaviruses and Australian bat lyssavirus
    Mackenzie JS, Field HE, Guyatt KJ
    J Appl Microbiol, 2003;94 Suppl:59S-69S.
    PMID: 12675937
    Since 1994, a number of novel viruses have been described from bats in Australia and Malaysia, particularly from fruit bats belonging to the genus Pteropus (flying foxes), and it is probable that related viruses will be found in other countries across the geographical range of other members of the genus. These viruses include Hendra and Nipah viruses, members of a new genus, Henipaviruses, within the family Paramyxoviridae; Menangle and Tioman viruses, new members of the Rubulavirus genus within the Paramyxoviridae; and Australian bat lyssavirus (ABLV), a member of the Lyssavirus genus in the family Rhabdoviridae. All but Tioman virus are known to be associated with human and/or livestock diseases. The isolation, disease associations and biological properties of the viruses are described, and are used as the basis for developing management strategies for disease prevention or control. These strategies are directed largely at disease minimization through good farm management practices, reducing the potential for exposure to flying foxes, and better disease recognition and diagnosis, and for ABLV specifically, the use of rabies vaccine for pre- and post-exposure prophylaxis. Finally, an intriguing and long-term strategy is that of wildlife immunization through plant-derived vaccination.
    Matched MeSH terms: Virus Diseases/diagnosis; Paramyxoviridae Infections/diagnosis; Rhabdoviridae Infections/diagnosis; Communicable Diseases, Emerging/diagnosis*
  13. Video-EEG telemetry: apparent manifestation of both epileptic and non-epileptic attacks causing potential diagnostic pitfalls
    Raymond AA, Gilmore WV, Scott CA, Fish DR, Smith SJ
    Epileptic Disord, 1999 Jun;1(2):101-6.
    PMID: 10937139
    Video-EEG telemetry is often used to support the diagnosis of non-epileptic seizures (NES). Although rare, some patients may have both epileptic seizures (ES) and NES. It is crucially important to identify such patients to avoid the hazards of inappropriate anticonvulsant withdrawal. To delineate the electroclinical characteristics and diagnostic problems in this group of patients, we studied the clinical, EEG and MRI features of 14 consecutive patients in whom separate attacks, considered to be both NES and ES were recorded using video-EEG telemetry. Only two patients were drug-reduced during the telemetry. Most patients had their first seizure (ES or NES) in childhood (median age 7 years; range: 6 months-24 years); 8/14 patients were female. Brain MRI was abnormal in 10/14 patients. Interictal EEG abnormalities were present in all patients; 13/14 had epileptiform and 1/14 only background abnormalities. Over 70 seizures were recorded in these 14 patients: in 12/14 patients, the first recorded seizure was a NES (p < 0.001), and 7 of these patients had at least one more NES before an ES was recorded. Only 3/14 patients had more than 5 NES before an ES was recorded. Recording a small number of apparently NES in an individual by no means precludes the possibility of additional epilepsy. Particular care should be taken, and multiple (> 5) seizure recording may be advisable, in patients with a young age of seizure onset, interictal EEG abnormalities, or a clear, potential aetiology for epilepsy.
    Matched MeSH terms: Brain Diseases/diagnosis; Diagnosis, Differential; Epilepsy/diagnosis*; Seizures/diagnosis*
  14. Combine-ARMS: a rapid and cost-effective protocol for molecular characterization of beta-thalassemia in Malaysia
    Tan KL, Tan JA, Wong YC, Wee YC, Thong MK, Yap SF
    Genet. Test., 2001;5(1):17-22.
    PMID: 11336396 DOI: 10.1089/109065701750168626
    Beta-thalassemia major patients have chronic anemia and are dependent on blood transfusions to sustain life. Molecular characterization and prenatal diagnosis of beta3-thalassemia is essential in Malaysia because about 4.5% of the population are heterozygous carriers for beta-thalassemia. The high percentage of compound heterozygosity (47.62%) found in beta-thalassemia major patients in the Thalassaemia Registry, University of Malaya Medical Centre (UMMC), Malaysia, also supports a need for rapid, economical, and sensitive protocols for the detection of beta-thalassemia mutations. Molecular characterization of beta-thalassemia mutations in Malaysia is currently carried out using ARMS, which detects a single beta-thalassemia mutation per PCR reaction. We developed and evaluated Combine amplification refractory mutation system (C-ARMS) techniques for efficient molecular detection of two to three beta-thalassemia mutations in a single PCR reaction. Three C-ARMS protocols were evaluated and established for molecular characterization of common beta-thalassemia mutations in the Malay and Chinese ethnic groups in Malaysia. Two C-ARMS protocols (cd 41-42/IVSII #654 and -29/cd 71-72) detected the beta-thalassemia mutations in 74.98% of the Chinese patients studied. The CARMS for cd 41-42/IVSII #654 detected beta-thalassemia mutations in 72% of the Chinese families. C-ARMS for cd 41-42/IVSI #5/cd 17 allowed detection of beta-thalassemia mutations in 36.53% of beta-thalassemia in the Malay patients. C-ARMS for cd 41-42/IVSI #5/cd 17 detected beta-thalassemia in 45.54% of the Chinese patients. We conclude that C-ARMS with the ability to detect two to three mutations in a single reaction provides more rapid and cost-effective protocols for beta-thalassemia prenatal diagnosis and molecular analysis programs in Malaysia.
    Matched MeSH terms: Prenatal Diagnosis/economics; Prenatal Diagnosis/methods; beta-Thalassemia/diagnosis*
  15. Duplication of the rectum: report of four cases and review of the literature
    Rajah S, Ramanujam TM, Anas SR, Jayaram G, Baskaran P, Ganesan J, et al.
    Pediatr Surg Int, 1998 Jul;13(5-6):373-6.
    PMID: 9639621
    Rectal duplications are rare anomalies. Recently, we observed four cases of rectal duplication, each presenting with different clinical features including chronic constipation, a prolapsing rectal "polyp, " a "growth" from the vulva, and acute retention of urine. The variety of clinical presentations may lead to delay in diagnosis and multiple operations.
    Matched MeSH terms: Cysts/diagnosis; Diagnosis, Differential; Intestinal Obstruction/diagnosis; Rectal Diseases/diagnosis
  16. Review of oral histoplasmosis in Malaysians
    Ng KH, Siar CH
    Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 1996 Mar;81(3):303-7.
    PMID: 8653464
    We reviewed biopsy records for 37 cases of oral histoplasmosis for patient characteristics, clinical features, and histopathologic findings. These represented cases diagnosed in the Division of Stomatology, Institute for Medical Research, Kuala Lumpur between July 1967 and October 1994. All were male patients who ranged in age from 11 to 79 years (mean age, 56.7 years). There were 40.6% Malays, 37.8% Chinese, 18.9% Indians, and 2.7% other races. Five patients with mouth lesions as the initial presenting lesions were proven to be cases of disseminated histoplasmosis. In the remaining cases apart from the biopsy-proven oral histoplasmosis lesions, the extent of the disease elsewhere was unknown. The majority of these lesions involved the gingiva, tongue, and palate in decreasing order of frequency. The most frequent presenting symptom was oral mucosal ulceration. Squamous cell carcinoma and tuberculosis were the two most common clinical differential diagnoses. Our present findings compare favorably with published reports from other regions.
    Matched MeSH terms: Carcinoma, Squamous Cell/diagnosis; Diagnosis, Differential; Mouth Neoplasms/diagnosis; Tuberculosis, Oral/diagnosis
  17. The surgical treatment of adrenal diseases
    Meah FA, Abdullah T, Jasmi AY, Hisham AN, Tan TT, Khalid BA, et al.
    Ann Acad Med Singap, 1996 Mar;25(2):251-4.
    PMID: 8799016
    Between January 1978 to December 1993, 130 cases of adrenal diseases were diagnosed and surgically treated at the National University of Malaysia. They were 58 cases (44.6%) of Conn's syndrome, 40 cases (30.7%) of Cushing's syndrome, 20 cases (15.3%) of phaeochromocytoma and 12 cases (9.2%) of adrenocortical carcinoma (ACC). The commonest cause of Conn's syndrome was an adenoma (96.5%) which affected the left gland four times more than the right gland. Cushing's syndrome was caused by adrenocortical adenoma (32.5%), diffuse bilateral adrenal hyperplasia (40.0%), pigmented macronodular hyperplasia (20.0%) and adrenal carcinoma (7.5%). Twenty-five percent of the phaeochromocytomas were extraadrenal in origin arising mainly from the abdominal sympathetic chain. More than 50% of ACCs were non-functioning tumours. Fifty percent of the patients with ACC had inoperable tumours. The prognosis was poor even with adjuvant chemoradiotherapy. The main surgical approach was the anterior transabdominal route. There was no operative mortality or morbidity in all operated cases.
    Matched MeSH terms: Adrenal Gland Diseases/diagnosis; Cushing Syndrome/diagnosis; Hyperaldosteronism/diagnosis; Pheochromocytoma/diagnosis
  18. Tarantism, dancing mania and demonopathy: the anthro-political aspects of 'mass psychogenic illness'
    Bartholomew RE
    Psychol Med, 1994 May;24(2):281-306.
    PMID: 8084927
    This study questions the widely held assumption that the phenomenon known as mass psychogenic illness (MPI) exists per se in nature as a psychiatric disorder. Most MPI studies are problematical, being descriptive, retrospective investigations of specific incidents which conform to a set of pre-existing symptom criteria that are used to determine the presence of collective psychosomatic illness. Diagnoses are based upon subjective, ambiguous categories that reflect stereotypes of female normality which assume the presence of a transcultural disease or disorder entity, underemphasizing or ignoring the significance of episodes as culturally conditioned roles of social action. Examples of this bias include the mislabelling of dancing manias, tarantism and demonopathy in Europe since the Middle Ages as culture-specific variants of MPI. While 'victims' are typified as mentally disturbed females possessing abnormal personality characteristics who are exhibiting cathartic reactions to stress, it is argued that episodes may involve normal, rational people who possess unfamiliar conduct codes, world-views and political agendas that differ significantly from those of Western-trained investigators who often judge these illness behaviours independent of their local context and meanings.
    Matched MeSH terms: Bipolar Disorder/diagnosis; Hysteria/diagnosis; Obsessive Behavior/diagnosis; Psychophysiologic Disorders/diagnosis
  19. Fulltext Endoscopy in upper gastrointestinal haemorrhage
    Jalleh RP, Goh KL, Wong NW
    Med J Malaysia, 1988 Sep;43(3):213-7.
    PMID: 3266521
    Matched MeSH terms: Duodenal Ulcer/diagnosis; Gastrointestinal Hemorrhage/diagnosis; Peptic Ulcer Hemorrhage/diagnosis; Stomach Ulcer/diagnosis
  20. Dengue Maculopathy Associated with Choroidopathy and Pseudohypopyon: A Case Series
    Ng CWK, Tai PY, Oli Mohamed S
    Ocul Immunol Inflamm, 2018;26(5):666-670.
    PMID: 27929712 DOI: 10.1080/09273948.2016.1254804
    Matched MeSH terms: Dengue/diagnosis; Retinal Diseases/diagnosis; Eye Infections, Viral/diagnosis; Choroid Diseases/diagnosis
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