Displaying publications 1041 - 1060 of 5836 in total

Abstract:
Sort:
  1. Fulltext Functional impairment as a proxy measure indicating high rates of trauma exposure, post-migration living difficulties, common mental disorders, and poor health amongst Rohingya refugees in Malaysia
    Tay AK, Rees S, Miah MAA, Khan S, Badrudduza M, Morgan K, et al.
    Transl Psychiatry, 2019 09 02;9(1):213.
    PMID: 31477686 DOI: 10.1038/s41398-019-0537-z
    A major challenge in the refugee field is to ensure that scarce mental health resources are directed to those in greatest need. Based on data from an epidemiological survey of 959 adult Rohingya refugees in Malaysia (response rate: 83%), we examine whether a brief screening instrument of functional impairment, the WHO Disability Assessment Schedule (WHODAS), prove useful as a proxy measure to identify refugees who typically attend community mental health services. Based on estimates of mental disorder requiring interventions from analyses of epidemiological studies conducted worldwide, we selected a WHODAS cutoff that identified the top one-fifth of refugees according to severity of functional impairment, the remainder being distributed to moderate and lower impairment groupings, respectively. Compared to the lower impairment grouping, the severe impairment category comprised more boat arrivals (AOR: 5.96 [95% CI 1.34-26.43); stateless persons (A20·11 [95% CI 7.14-10); those with high exposure to pre-migration traumas (AOR: 4.76 [95% CI 1.64-13.73), peri-migration stressors (AOR: 1.26 [95% CI 1.14-1.39]) and postmigration living difficulties (AOR: 1.43 [95% CI 1.32-1.55); persons with single (AOR: 7.48 [95% CI 4.25-13.17]) and comorbid (AOR: 13.54 [95% CI 6.22-29.45]) common mental disorders; and those reporting poorer general health (AOR: 2.23 [95% CI 1-5.02]). In addition, half of the severe impairment grouping (50.6%) expressed suicidal ideas compared to one in six (16.2 percent) of the lower impairment grouping (OR: 2.39 [95% CI 1.94-2.93]). Differences between the severe and moderate impairment groups were similar but less extreme. In settings where large-scale epidemiological studies are not feasible, the WHODAS may serve as readily administered and brief public health screening tool that assists in stratifying the population according to urgency of mental health needs.
    Matched MeSH terms: Mental Disorders/diagnosis*; Depression/diagnosis*; Stress Disorders, Post-Traumatic/diagnosis; Stress, Psychological/diagnosis*
  2. Fulltext Arthritis as an initial presentation of malignancy: two case reports
    Sachdev Manjit Singh B, Wan SA, Cheong YK, Chuah SL, Teh CL, Jobli AT
    J Med Case Rep, 2021 Feb 23;15(1):94.
    PMID: 33618728 DOI: 10.1186/s13256-020-02642-z
    BACKGROUND: Arthritis is rarely reported as a paraneoplastic manifestation of occult malignancy. We report herein two cases of paraneoplastic arthritis due to occult malignancy. CASE 1: The patient was a 65-year-old woman of asian descent who was a former smoker with a history of spine surgery performed for L4/L5 degenerative disc disease. She presented with a 1-month history of oligoarthritis affecting both ankle joints and early morning stiffness of about 3 hours. Laboratory tests were positive for antinuclear antibody at a titer of 1:320 (speckled) but negative for rheumatoid factor. She was treated for seronegative spondyloarthritis and started on prednisolone without much improvement. A routine chest radiograph incidentally revealed a right lung mass which was found to be adenocarcinoma of the lung. She was treated with gefitinib and her arthritis resolved. CASE 2: The patient was a 64-year-old woman of asian descent, nonsmoker, who presented with a chief complaint of asymmetrical polyarthritis involving her right wrist, second and third metacarpophalangeal joints, and first to fifth proximal interphalangeal joints. She was treated for seronegative rheumatoid arthritis (RA) and started on sulfasalazine, with poor clinical response. Six months later, she developed abdominal pain which was diagnosed as ovarian carcinoma by laparotomy. Her arthritis resolved following treatment of her malignancy with chemotherapy.

    CONCLUSION: In summary, paraneoplastic arthritis usually presents in an atypical manner and responds poorly to disease-modifying antirheumatic drugs. Accordingly, we recommend screening for occult malignancy in patients presenting with atypical arthritis.

    Matched MeSH terms: Carcinoma/diagnosis; Lung Neoplasms/diagnosis; Ovarian Neoplasms/diagnosis; Paraneoplastic Syndromes/diagnosis*
  3. The great masquerade: Empyema thoracis as an unusual presentation of primary lung malignancy
    Nyanti LE, Kho SS, Tie ST
    Med J Malaysia, 2019 02;74(1):79-81.
    PMID: 30846667
    Primary lung malignancy presenting as empyema is rare, with a reported incidence of 0.3%. We report a case of a 60- year-old man presenting with unilateral pleural effusion; diagnostic thoracocentesis confirmed Salmonella empyema. Post-drainage, chest radiograph showed persisting right hemithorax opacity; subsequent computed tomography revealed a right lung mass with right upper lobe bronchus obliteration. Percutaneous biopsy confirmed advanced stage lung adenocarcinoma. We discuss the mechanism of post-obstructive pneumonia in lung cancerassociated empyema and the utility of bedside ultrasound in diagnosis of lung masses. Clinicians are alerted to the possibility of lung malignancy in elderly patients presenting with empyema.
    Matched MeSH terms: Adenocarcinoma/diagnosis*; Lung Neoplasms/diagnosis*; Salmonella Infections/diagnosis; Empyema, Pleural/diagnosis*
  4. Paraneoplastic relapsing minimal change disease associated with type A thymoma in an elderly patient: A case report and literature review
    Ngoh CLY, Goh GHS, Wong WK
    Med J Malaysia, 2019 02;74(1):97-98.
    PMID: 30846674
    Thymoma is a rare mediastinal tumour that can be accompanied by different paraneoplastic syndromes. Here we report a case of Type A thymoma associated with relapsing minimal change disease (MCD). This case highlights: (1) The need to balance rapid prednisolone weaning against risk for relapse in an elderly patient at risk for steroid-induced complications. (2) The addition of calcineurin inhibitor in relapsed thymoma-related MCD, to achieve steroid sparing effects. Resection of the offending tumour and prompt immunosuppressive therapy are critical in getting best renal and overall outcomes in this rare entity.
    Matched MeSH terms: Nephrosis, Lipoid/diagnosis; Paraneoplastic Syndromes/diagnosis; Thymoma/diagnosis; Thymus Neoplasms/diagnosis
  5. Fulltext Infected aneurysm after returning from Southeast Asia: think Burkholderia pseudomallei!
    Auvens C, Neuwirth C, Piroth L, Blot M
    BMJ Case Rep, 2019 May 22;12(5).
    PMID: 31122956 DOI: 10.1136/bcr-2018-228856
    Melioidosis is a protean disease which is endemic to Southeast Asia and northern Australia. Here, we report a case of infected aortic aneurysm due to Burkholderia pseudomallei in an immunocompetent man 6 months after a trip to northern Malaysia. This patient initially received inappropriate surgical and antibiotic treatment, leading to a peri-prosthetic aortic infection with lumbar spondylitis and contiguous psoas muscle abscess. This case highlights the difficulty of diagnosing melioidosis given its diverse clinical manifestations and the limits of routine microbiological methods to identify B. pseudomallei Melioidosis should be considered a possible diagnosis in individuals with unexplained fever subsequent to travel in an endemic area.
    Matched MeSH terms: Aneurysm, Infected/diagnosis*; Diagnosis, Differential; Melioidosis/diagnosis*; Pyelonephritis/diagnosis*
  6. Disseminated thymic B-cell lymphoma in a Holstein heifer
    Hishamnuri WNAD, Nakagun S, Maezawa M, Sakaguchi K, Akiyama N, Watanabe KI, et al.
    J Vet Diagn Invest, 2019 Nov;31(6):852-855.
    PMID: 31551023 DOI: 10.1177/1040638719875501
    A 19-mo-old Holstein heifer was inactive and dyspneic. Physical examination revealed wheezing, exophthalmos, a cervical mass, and lymphadenopathy. Cytology of the cervical mass and lymph nodes showed predominantly large atypical lymphocytes. Lactate dehydrogenase and thymidine kinase activities were elevated. Although nested PCR for bovine leukemia virus (BLV) using blood was positive, quantitative PCR showed a low number of provirus copies. Autopsy revealed enlargement of most lymph nodes examined, as well as white masses of various sizes in muscles of the left hindlimb and thoracic and abdominal organs. Histopathology revealed severe infiltration with neoplastic lymphocytes in these organs. The cervical mass was immune-positive for B-cell markers. The final diagnosis was thymic B-cell lymphoma with BLV infection.
    Matched MeSH terms: Cattle Diseases/diagnosis*; Thymus Neoplasms/diagnosis; Lymphoma, B-Cell/diagnosis*; Enzootic Bovine Leukosis/diagnosis*
  7. Fulltext Case series of naturally acquired Plasmodium knowlesi infection in a tertiary teaching hospital
    Azira NM, Zairi NZ, Amry AR, Zeehaida M
    Trop Biomed, 2012 Sep;29(3):398-404.
    PMID: 23018503 MyJurnal
    Plasmodium knowlesi is a simian malaria parasite and is recently recognized as the fifth malaria parasite infecting humans. Manifestation of the infection may resemble other infection particularly dengue fever leading to inappropriate management and delay in treatment. We reported three cases of naturally acquired P. knowlesi in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. Clinical manifestations were quite similar in those cases. Microscopically, the diagnosis might be challenging. These cases were confirmed by polymerase chain reaction method which serves as a gold standard.
    Matched MeSH terms: Dengue/diagnosis; Diagnosis, Differential; Malaria/diagnosis*; Thrombocytopenia/diagnosis*
  8. Fulltext Bartonella henselae Neuroretinitis: A Rare Coinfection in POEMS Syndrome
    Ab Kahar MEPI, Muhammed J, Hitam WHW, Husin A
    Turk J Ophthalmol, 2020 12 29;50(6):371-376.
    PMID: 33389938 DOI: 10.4274/tjo.galenos.2020.83873
    Bartonella henselae is a recognized cause of neuroretinitis in cat scratch disease. Meanwhile, polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, skin changes (POEMS) syndrome with Castleman disease (evidence of lymph node hyperplasia), is a chronic debilitating condition that predisposes to various superimposed infections. B. henselae neuroretinitis implicated in POEMS syndrome has not been reported previously. A 34-year-old asymptomatic man was referred for an eye assessment. Examination showed visual acuity of 6/18 in the right eye and 6/24 in the left eye. On fundus examination, both eyes exhibited typical features of neuroretinitis (optic disc swelling and incomplete macular star). There was otherwise no vitritis or chorioretinitis. Serology for B. henselae revealed high immunoglobulin M (IgM) titer (1:96) indicative of acute disease, and positive immunoglobulin G (IgG) (1:156). He was treated with oral azithromycin for 6 weeks and a short course of oral prednisolone. Subsequently, the visual acuity in both eyes improved with resolution of macular star. However, both optic discs remained swollen.
    Matched MeSH terms: Bartonella Infections/diagnosis*; Retinitis/diagnosis*; Eye Infections, Bacterial/diagnosis*; POEMS Syndrome/diagnosis
  9. Musculoskeletal lesions in yaws
    Sengupta S
    Clin Orthop Relat Res, 1985 Jan-Feb;?(192):193-8.
    PMID: 3967422
    Yaws, a spirochetal infection that is endemic in certain tropical countries, including Malaysia, may present with various orthopedic problems. As the condition is relatively unknown, diagnosis is often missed, which leads to poor management. There are initial, early, and late phases of the disease process. By involving skin, bone, and joints, yaws can produce deep ulcerations, joint deformities, and bone destruction. Within a ten-year period in Malaysia, 14 cases of serologically proven yaws have been treated for chronic ulcers, gross joint deformities, and pathologic fractures.
    Matched MeSH terms: Bone Diseases/diagnosis; Diagnosis, Differential; Syphilis/diagnosis; Yaws/diagnosis
  10. Fulltext A novel de novo mutation in COL2A1 gene associated with fetal skeletal dysplasia
    Chu FC, Hii LY, Hung TH, Lo LM, Hsieh TT, Shaw SW
    Taiwan J Obstet Gynecol, 2021 Mar;60(2):359-362.
    PMID: 33678343 DOI: 10.1016/j.tjog.2021.01.017
    OBJECTIVE: Skeletal dysplasias, caused by genetic mutations, are a heterogenous group of heritable disorders affecting bone development during fetal life. Stickler syndrome, one of the skeletal dysplasias, is an autosomal dominant connective tissue disorder caused by abnormal collagen synthesis owing to a genetic mutation in COL2A1.

    CASE REPORT: We present the case of a 38-year-old multipara woman whose first trimester screening showed a normal karyotype. However, the bilateral femur and humerus length symmetrically shortened after 20 weeks. Next-generation sequencing for mutations in potential genes leading to skeletal dysplasia detected a novel de novo mutation (c.1438G > A, p.Gly480Arg) in COL2A1, causing Stickler syndrome type 1. This pathogenic mutation might impair or destabilize the collagen structure, leading to collagen type II, IX, and XI dysfunction.

    CONCLUSION: We identified a novel de novo mutation in COL2A1 related to the STL1 syndrome and delineated the extent of the skeletal dysplasia disease spectrum.

    Matched MeSH terms: Arthritis/diagnosis*; Connective Tissue Diseases/diagnosis*; Hearing Loss, Sensorineural/diagnosis*; Retinal Detachment/diagnosis*
  11. Allergic contact dermatitis caused by latex gloves in a dental undergraduate student
    Chaubal TV, Bapat RA, Patil PG, Shetty A
    Contact Derm., 2016 Oct;75(4):256-7.
    PMID: 27620128 DOI: 10.1111/cod.12625
    Matched MeSH terms: Hand Dermatoses/diagnosis; Dermatitis, Occupational/diagnosis; Dermatitis, Allergic Contact/diagnosis; Latex Hypersensitivity/diagnosis
  12. Pyopneumothorax secondary to Streptococcus milleri infection
    Che Rahim MJ, Mohammad N, Wan Ghazali WS
    BMJ Case Rep, 2016 Nov 23;2016.
    PMID: 27881590 DOI: 10.1136/bcr-2016-217537
    We report a case of a 46-year-old Malay woman with underlying hypothyroidism post thyroidectomy who presented with worsening breathlessness, orthopnoea, productive cough and left-sided pleuritic chest pain of 3 days duration. Chest X-ray on admission showed left-sided massive hydropneumothorax. Pleural tapping revealed empyema. A chest tube was inserted immediately. The culture of pleural fluid grew Streptococcus constellatus The patient was treated with antibiotics for a total of 6 weeks and underwent open thoracotomy and decortication during admission. Subsequently, her lung condition improved and there was no evidence of recurrence during follow-up.
    Matched MeSH terms: Diagnosis, Differential; Hydropneumothorax/diagnosis; Streptococcal Infections/diagnosis; Empyema, Pleural/diagnosis
  13. Identifying and treating foot ulcers in patients with diabetes: saving feet, legs and lives
    Ousey K, Chadwick P, Jawien A, Tariq G, Nair HKR, Lázaro-Martínez JL, et al.
    J Wound Care, 2018 05 01;27(Sup5):S1-S52.
    PMID: 29738280 DOI: 10.12968/jowc.2018.27.Sup5.S1
    Matched MeSH terms: Pressure Ulcer/diagnosis; Diabetic Neuropathies/diagnosis*; Ischemia/diagnosis*; Diabetic Foot/diagnosis*
  14. Pleural fluid lactate as a point-of-care adjunct diagnostic aid to distinguish tuberculous and complicated parapneumonic pleural effusions during initial thoracentesis: Potential use in a tuberculosis endemic setting
    Kho SS, Chan SK, Yong MC, Cheah HM, Lee YG, Tie ST
    Respir Investig, 2020 Sep;58(5):367-375.
    PMID: 32107195 DOI: 10.1016/j.resinv.2020.01.004
    BACKGROUND: Tuberculous pleural effusions (TBEs) and parapneumonic pleural effusion (PPEs) have similar clinical presentations and fluid biochemistry. A pleural biopsy is usually required to diagnose TBE but complete fluid evacuation may not be necessary, contrasting with complicated PPE (CPPE). A point-of-care test that distinguishes between TBE and CPPE enables the appropriate procedures to be performed during the initial diagnostic thoracentesis. Lactate is a metabolic product measurable by a blood-gas analyzer. This study measured pleural fluid (Pf) lactate levels in TBE and compared them with those in PPE/CPPE. We hypothesized that Pf lactate would be significantly higher in PPE because of active metabolic activities than in TBE which is driven by delayed hypersensitivity.

    METHODS: All patients undergoing an initial diagnostic thoracentesis over 18 months with Pf lactate measured using a calibrated point-of-care blood gas analyzer were assessed.

    RESULTS: The diagnoses of the enrolled patients (n = 170) included TBE (n = 49), PPE (n = 47), malignancy (n = 63), and transudate (n = 11). Pf lactate level in TBE, median 3.70 (inter-quartile range 2.65-4.90) mmol/l, was significantly lower than in PPE and CPPE. In the subgroup of TBE and CPPE patients whose initial Pf pH and glucose could suggest either condition, Pf lactate was significantly higher in those with CPPE. Pf lactate (cutoff ≥7.25 mmol/l) had a sensitivity of 79.3%, specificity 100%, positive predictive value 100%, and negative predictive value 89.1% for discriminating CPPE from TBE (area under the curve 0.947, p 

    Matched MeSH terms: Diagnosis, Differential; Pleural Effusion/diagnosis*; Tuberculosis, Pleural/diagnosis*; Early Diagnosis
  15. Fulltext Persistent oromandibular dystonia and angioedema secondary to haloperidol
    Masiran R
    BMJ Case Rep, 2017 Oct 04;2017.
    PMID: 28978587 DOI: 10.1136/bcr-2017-220817
    We report a case in a young man who developed acute, persistent and painful tongue protrusion followed by swelling for more than 24 hours. He had relapse symptoms of schizophrenia and had recently received a single dose of parenteral haloperidol to manage his agitation. His record showed history of similar event and he has been taking atypical antipsychotic for maintenance. Mental state examination on admission revealed an agitated man with disorganised speech, restricted affect, auditory hallucination and persecutory delusion. His dystonia and oedema improved after 3 days. His mental status also recovered with the maintenance of low-potency antipsychotic and anticholinergic antiparkinsonian medications.
    Matched MeSH terms: Angioedema/diagnosis*; Diagnosis, Differential; Dystonia/diagnosis*; Tongue Diseases/diagnosis*
  16. Relapse of B-cell acute lymphoblastic leukaemia presenting as right aural polyp with facial and mandibular nerves palsy
    Shiun Chuen C, Md Daud MK, Che Jalil NA, Hazmi H
    Med J Malaysia, 2017 10;72(5):318-320.
    PMID: 29197892 MyJurnal
    A patient presenting with an ear polyp is a common finding in otorhinolaryngology practice. The common causes include chronic otitis media and cholesteatoma. We report an adult female patient with a history of acute leukaemia presenting with chronic otitis media symptoms and right ear polyp. She was subsequently diagnosed as relapse of B-cell acute lymphoblastic leukaemia based on histopathological examination. The presentation may be similar to an inflammatory pathology of the middle ear, making it misleading.
    Matched MeSH terms: Diagnosis, Differential; Ear Neoplasms/diagnosis; Neoplasm Recurrence, Local/diagnosis*; Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis*
  17. Leprae reaction resembling rheumatologic disease as presenting feature of leprosy
    Baharuddin H, Taib T, Zain MM, Ch'ng S
    Int J Rheum Dis, 2016 Oct;19(10):1035-1038.
    PMID: 27456320 DOI: 10.1111/1756-185X.12916
    Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae with predominant involvement of skin and nerves. We present a 70-year-old man with leprosy whose initial presentation resembled rheumatologic disease, due to leprae reaction. He presented with an 8-week history of worsening neuropathic pain in the right forearm, associated with necrotic skin lesions on his fingers that had ulcerated. Physical examination revealed two tender necrotic ulcers at the tip of the right middle finger and the dorsal aspect of the left middle finger. The patient had right wrist tenosynovitis and right elbow bursitis. Apart from raised inflammatory markers, the investigations for infection, connective tissue disease, vasculitis, thromboembolic disease and malignancy were negative. During the fourth week of hospitalization, we noticed a 2-cm hypoesthetic indurated plaque on the right inner arm. Further examination revealed thickened bilateral ulnar, radial and popliteal nerves. A slit skin smear was negative. Two skin biopsies and a biopsy of the olecranon bursa revealed granulomatous inflammation. He was diagnosed with paucibacillary leprosy with neuritis. He responded well to multidrug therapy and prednisolone; his symptoms resolved over a few weeks. This case illustrates the challenges in diagnosing a case of leprosy with atypical presentation in a non-endemic country.
    Matched MeSH terms: Diagnosis, Differential; Rheumatic Diseases/diagnosis*; Leprosy, Lepromatous/diagnosis*; Leprosy, Tuberculoid/diagnosis*
  18. Fulltext Pulmonary nocardiosis in a child with hyperimmunoglobulin E syndrome
    Lee WS, Boey CC, Goh AY
    Singapore Med J, 1999 Apr;40(4):278-80.
    PMID: 10487085
    Hyperimmunoglobulin E syndrome (HIE) is a rare condition characterised by marked elevation of serum IgE level, chronic dermatitis, intense pruritus, and recurrent serious infection. The major organism is usually S aureus. We report a case of an infant with HIE, who had pulmonary nocardiosis. The clinical features, immunological abnormalities, and radiological features of the condition are described. The child finally succumbed to the complications of pulmonary nocardiosis.
    Matched MeSH terms: Job Syndrome/diagnosis*; Nocardia Infections/diagnosis*; Opportunistic Infections/diagnosis; Pneumonia, Bacterial/diagnosis*
  19. Fulltext Subdural collections due to non-typhi Salmonella infections in two Malaysian children
    Intan HI, Zubaidah CD, Norazah A, Norlijah O
    Singapore Med J, 2008 Jul;49(7):e186-9.
    PMID: 18695854
    Subdural collections caused by Salmonella infection are rarely encountered in children. We present two cases caused by non-typhi Salmonella, one a four-and-a-half-month-old boy presenting with subdural effusion, and the other, a 16-month-old boy with empyema. The diagnosis was confirmed on blood and subdural pus cultures. One patient had status epilepticus following focal fit, and the other had prolonged fever without any localising signs of infection on admission. They responded well to prompt surgical drainage and prolonged systemic antibiotic therapy. Contrary to previous reports, both patients showed favourable outcome in terms of neurological sequelae.
    Matched MeSH terms: Brain Abscess/diagnosis; Salmonella Infections/diagnosis; Status Epilepticus/diagnosis; Empyema, Subdural/diagnosis
  20. Fulltext Angioinvasive cerebral aspergillosis presenting as acute ischaemic stroke in a patient with diabetes mellitus
    Norlinah MI, Ngow HA, Hamidon BB
    Singapore Med J, 2007 Jan;48(1):e1-4.
    PMID: 17245496
    Cerebral angioinvasive aspergillosis is a rare manifestation of disseminated aspergillosis which may result in stroke in immunocompromised individuals. Reports of such disease in patients with diabetes mellitus are rare. We describe a 45-year-old man with diabetes mellitus who presented with a three-day history of right-sided limb weakness and aphasia. Cerebral computed tomography showed features of an acute infarct involving the left anterior and middle cerebral arteries. He was initially treated for an acute ischaemic stroke. Further history revealed that he was investigated for a growth in the sphenoid sinus two months earlier. Culture of the biopsied material from the sphenoid sinus grew Aspergillus fumigatus. Magnetic resonance imaging showed an extension of the growth to the brain, causing the acute ischaemic stroke. He was subsequently diagnosed with angioinvasive cerebral aspergillosis and was commenced on intravenous amphotericin B. Unfortunately, he succumbed to his illness despite treatment.
    Matched MeSH terms: Diagnosis, Differential; Infarction, Anterior Cerebral Artery/diagnosis*; Infarction, Middle Cerebral Artery/diagnosis*; Neuroaspergillosis/diagnosis*
Related Terms
Filters
Contact Us

Please provide feedback to Administrator ([email protected])

External Links