Displaying publications 1561 - 1580 of 5844 in total

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  1. Nah SA, Tan HL, Tamba RP, Aziz DA, Azzam N
    J Pediatr Surg, 2011 Feb;46(2):424-7.
    PMID: 21292104 DOI: 10.1016/j.jpedsurg.2010.11.045
    Necrotizing enterocolitis has a wide clinical spectrum of manifestation. We report a novel method of managing focal isolated perforation in necrotizing enterocolitis by using diagnostic laparoscopy to localize the site of perforation and by making a microincision over the perforation to perform exteriorization or limited resection and primary anastomosis.
    Matched MeSH terms: Diagnosis, Differential; Intestinal Perforation/diagnosis*; Enterocolitis, Necrotizing/diagnosis
  2. Haflah NH, Ibrahim S, Sapuan J, Abdullah S
    J Pediatr Orthop B, 2010 Sep;19(5):459-61.
    PMID: 20555271 DOI: 10.1097/BPB.0b013e32833b6032
    Elbow dislocations associated with a medial epicondyle fracture and ulnar nerve palsy are uncommon injuries. We present the case of an 11-year-old girl with an elbow dislocation treated by closed manual reduction. The medial epicondyle fracture was missed initially until she developed an ulnar nerve palsy 2 months later. Intraoperatively we discovered the bony epicondyle piercing the joint capsule and compressing the ulnar nerve. Removal of the bony fragment relieved her symptoms and she returned to normal activities at 1 year follow-up. We would like to highlight this rare occurrence and present the detailed history and management of this case.
    Matched MeSH terms: Humeral Fractures/diagnosis*; Delayed Diagnosis*
  3. Khoo JJ, Alwi RI, Abd-Rahman I
    Malays J Pathol, 2009 Jun;31(1):77-80.
    PMID: 19694319 MyJurnal
    Breast hamartoma is an uncommon poorly recognised benign breast neoplasm. Hamartoma displaying marked smooth muscle components known as myoid hamartoma of the breast is a much rarer entity. We present a case of myoid hamartoma of breast with chondroid differentiation in a 46-year-old woman. The painless breast lump was circumscribed and mammography showed a well-encapsulated large, dense mass with no calcification. Core needle biopsy was reported as fibroadenoma. The lesion was excised. Microscopically, it composed of many groups of mammary glandular components with dense fibrous stroma, adipose tissue and marked groups of smooth muscle fibres. Foci of chondroid differentiation were noted in the lesion. The smooth muscle cells showed strong and diffuse immunoreactivity for vimentin, myogloblin, alpha-smooth muscle actin, desmin and CD34 and failed to express pan-cytokeratin or S100 protein. The ducts lined by epithelial cells were reactive to pan-cytokeratin while the myoepithelial cells were reactive to S100 protein. The various immuno-histochemical staining as well as the cyto-histological changes encountered in myoid hamartomas are discussed with clinical, radiological and pathological correlation to differentiate it from other benign and malignant breast lesions.
    Matched MeSH terms: Breast Neoplasms/diagnosis; Diagnosis, Differential; Fibroadenoma/diagnosis
  4. Ooi ET, Ganesananthan S, Anil R, Kwok FY, Sinniah M
    Med J Malaysia, 2008 Dec;63(5):401-5.
    PMID: 19803300
    This is a retrospective study of the gastrointestinal symptoms, signs and laboratory parameters in adult dengue patients admitted to Kuala Lumpur Hospital from 1st December 2004 to 31st December 2004. Clinical and laboratory parameters that may predict the need for intensive care were investigated. Six hundred sixty-six patients with clinical and biochemical features consistent with dengue infection were identified. Patients were stratified into those who required intensive care and those who were managed in non high dependency wards. Serum alanine aminotransaminase (ALT) levels were normal in 22.8% of patients and 5.9% of patients had acute fulminant hepatitis. More patients with dengue haemorrhagic fever (DHF) had elevated ALT levels as compared to patients with classic dengue fever (DF) (p = 0.012). Patients with DF had a statistically significant lower mean ALT level as compared to patients with DHF. Abdominal pain (p = 0.01) and tenderness (p<0.001), gastrointestinal bleed (p<0.001), jaundice (p<0.001), hepatomegaly (p<0.001) and ascites (p<0.001) were predictors of need for intensive care. We conclude that gastrointestinal manifestations are very common in dengue patients. Presence of abdominal pain and tenderness, gastrointestinal bleed, jaundice, hepatomegaly and ascites can be used to triage patients requiring intensive care.
    Matched MeSH terms: Dengue/diagnosis; Gastrointestinal Diseases/diagnosis; Liver Failure, Acute/diagnosis
  5. Reza AW, Eswaran C, Hati S
    J Med Syst, 2009 Feb;33(1):73-80.
    PMID: 19238899
    The detection of bright objects such as optic disc (OD) and exudates in color fundus images is an important step in the diagnosis of eye diseases such as diabetic retinopathy and glaucoma. In this paper, a novel approach to automatically segment the OD and exudates is proposed. The proposed algorithm makes use of the green component of the image and preprocessing steps such as average filtering, contrast adjustment, and thresholding. The other processing techniques used are morphological opening, extended maxima operator, minima imposition, and watershed transformation. The proposed algorithm is evaluated using the test images of STARE and DRIVE databases with fixed and variable thresholds. The images drawn by human expert are taken as the reference images. The proposed method yields sensitivity values as high as 96.7%, which are better than the results reported in the literature.
    Matched MeSH terms: Diabetic Retinopathy/diagnosis; Eye Diseases/diagnosis*; Glaucoma/diagnosis
  6. Othman NH, Nor ZM, Biswal BM
    Asian Pac J Cancer Prev, 2008 Jul-Sep;9(3):473-8.
    PMID: 18990023
    OBJECTIVE: To determine the trend of cancer cases in one major hospital in Kelantan over a 20 year period from 1987 to 2007 and to speculate the change in trend due to the socio-economic and other health status in the state.

    METHODOLOGY: All data on clinically diagnosed cancer cases in Hospital Universiti Sains Malaysia [HUSM] were retrieved from the hospital medical records. The cancers were classified according to ICD10 and scrutinized to avoid duplicate or more entries. The increment in cancer incidence was calculated based on total numbers of cancer cases per each 5-6 year period.

    RESULTS: A total of 12,228 solid cancers were diagnosed during the period. There is an increment of 20.1% for 1991-1996 from 1987-1990 period, 67.4% for 1997-2001 from 1991-1996 period and 305.9% for 2002-2007 from the 1997-2001 period. The rise was steep in the last 5-6 years. After excluding referred cases from states outside Kelantan, the increments were 20.1%, 67.4% and 143.6% for the consecutive 5-6 year periods. The predominant rising trends were seen for cancers of the female organs, digestive tract and endocrine organs.

    CONCLUSION: Cancer cases in HUSM are showing a rising trend, associated with increasing prevalence of smoking, obesity and diabetes in the community served by the hospital. Since HUSM is the only hospital managing cancer in the state of Kelantan, to reduce cancer incidence in the state, life-style issues need to be addressed.
    Matched MeSH terms: Diabetes Mellitus/diagnosis; Neoplasms/diagnosis*; Obesity/diagnosis
  7. Norhayati M, Azlin M, Al-Mekhlafi MH, Anisah N, Nor Aini U, Fatmah MS, et al.
    Trans R Soc Trop Med Hyg, 2008 Dec;102(12):1274-8.
    PMID: 18602128 DOI: 10.1016/j.trstmh.2008.05.019
    An observational study was carried out to establish the existence of intestinal microsporidiosis among patients with and without gastrointestinal symptoms in Hospital Universiti Kebangsaan Malaysia, Malaysia. A total of 893 faecal specimens from hospitalized patients were examined for microsporidia using a modification of the usual Gram-chromotrope stain technique. One hundred and sixteen (13.0%) patients were positive for microsporidia: 84 (72.4%), 27 (23.3%) and 5 (4.3%) were low, moderate and high excreters of microsporidia spores, respectively. Of the 91 patients with available medical records, microsporidiosis was commonly observed in children aged 0-6 years (26.4%) and adults aged >or=31 years (57.2%). About one-third of this infection was observed in immunocompetent individuals. Among the immunosuppressive group, microsporidia were observed to be more prevalent in patients with haematological malignancy or a combination of malignancy and diabetes mellitus. About 74% of the patients who had microsporidia in their faeces had gastrointestinal symptoms, which could be related to infections or induced by immunosuppressive therapy. The role of microsporidia in causing gastrointestinal symptoms in this population is as yet unclear.
    Matched MeSH terms: Intestinal Diseases/diagnosis; Opportunistic Infections/diagnosis; Microsporidiosis/diagnosis
  8. Masaany M, Siti HS, Nurliza I, Mazita A
    Otolaryngol Head Neck Surg, 2008 Jun;138(6):803-4.
    PMID: 18503863 DOI: 10.1016/j.otohns.2008.02.020
    Cholesterol granuloma (CG) is a histologic description of foreign body giant cell formation toward cholesterol crystals. The majority of temporal bone CG is unilateral and most common in the petrous apex. Middle ear CG is usually the result of underlying ear diseases. Primary middle ear CG is very rare. Most reported CG has not been associated with familial hypercholesterolemia (FH). FH, an autosomal dominant disorder, manifests as high levels of serum cholesterol and low density lipoprotein (LDL) cholesterol. We report a rare case of FH and bilateral aggressive primary middle ear CG. This publication has been approved by the IRB, Hospital Alor Setar.
    Matched MeSH terms: Ear Diseases/diagnosis; Hyperlipoproteinemia Type II/diagnosis; Granuloma, Foreign-Body/diagnosis
  9. Wee YC, Tan KL, Kuldip K, Tai KS, George E, Tan PC, et al.
    Community Genet, 2008;11(3):129-34.
    PMID: 18376108 DOI: 10.1159/000113874
    BACKGROUND/AIMS: Individuals with double heterozygosity for alpha- and beta-thalassaemia and heterozygous beta-thalassaemia show a similar haematological picture. Co-inheritance of alpha- and beta-thalassaemia in both partners may result in pregnancies with either Hb Bart's hydrops foetalis or beta-thalassaemia major, or pregnancies with both disorders.
    METHODS: The co-inheritance of alpha-thalassaemia in 322 beta-thalassaemia carriers in Malaysia was studied.
    RESULTS: The frequency of alpha-thalassaemia in the beta-thalassaemia carriers was 12.7% (41/322), with a carrier frequency of 7.8% for the SEA deletion, 3.7% for the -alpha(3.7) deletion, 0.9% for Hb Constant Spring and 0.3% for the -alpha(4.2) deletion.
    CONCLUSION: Double heterozygosity for alpha- and beta-thalassaemia was confirmed in 5 out of the 41 couples and the risk of the fatal condition Hb Bart's hydrops foetalis was confirmed in two of these couples. Detection of the Southeast Asian (SEA) deletion in the Malaysian Malays in this study confirms that Hb Bart's hydrops foetalis can occur in this ethnic group. Results of this study have provided new information on the frequency and different types of alpha-thalassaemia (--(SEA), -alpha(3.7) and -alpha(4.2) deletions, Hb Constant Spring) in Malaysian beta-thalassaemia carriers.
    Matched MeSH terms: Prenatal Diagnosis; alpha-Thalassemia/diagnosis; beta-Thalassemia/diagnosis
  10. Zulkiflee AB, Prepageran N, Philip R
    Am J Otolaryngol, 2008 Jan-Feb;29(1):72-4.
    PMID: 18061838 DOI: 10.1016/j.amjoto.2007.02.004
    INTRODUCTION: Melioidosis is a life-threatening disease caused by B. pseudomallei. It is endemic in Southeast Asia with a few reports from the Western world. It is transmitted via inhalation, ingestion or direct contact with an open wound. Clinically it may present with local or systemic symptoms. Mortality rate is very high in systemic disease; but local infection is usually mild, which causes delay in seeking medical attention.
    CASE REPORT: We report a case of neck melioidosis presenting as a parapharyngeal abscess that was successfully managed with incision and drainage and intravenous ceftazidime and co-trimoxazole for 6 weeks followed by eradication therapy with oral co amoxiclav.
    CONCLUSION: Neck melioidosis must be considered one of differential diagnoses for "cold abscesses" of the neck, especially in an endemic area, in Asian migrants, or in those with history of previous visit from the endemic regions.
    Matched MeSH terms: Abscess/diagnosis; Diagnosis, Differential; Melioidosis/diagnosis
  11. Ng TG, Ayadurai K, Gangaram HB, Hussein SH
    Med J Malaysia, 2006 Dec;61(5):586-91.
    PMID: 17623960 MyJurnal
    Subcutaneous panniculitic T-cell lymphoma (SPTL) is a rare variant of cutaneous T-cell lymphoma where lymphoma cells infiltrate preferentially into subcutaneous tissue. Five cases of SPTL were seen during the period from 2001-2004 at the Department of Dermatology, Hospital Kuala Lumpur. All five presented with multiple subcutaneous nodules on the face, trunk and limbs of one week to six months duration with associated fever and loss of weight. Physical examination showed multiple tender, erythematous indurated plaques and subcutaneous nodules on their face, trunk and limbs. One patient also presented with unhealing ulcerated nodules. Two patients had hepatosplenomegaly and one hepatomegaly. Two patients had pancytopaenia while the other three had leucopaenia. One patient had deranged liver function. Out of the five patients, three had bone marrow examination with haemophaegocytosis in two and one hypocellular marrow. Skin biopsy of all patients showed infiltration with atypical lymphoid cells in the upper dermis and subcutaneous fat. These neoplastic cells showed positivity for CD3 and CD30 in three patients with CD8, TIA-1 and LCA (Leucocyte common antigen) being positive in one patient. One patient treated with prednisolone and subcutaneous Roferon 3Mu three times a week since 2001 was in remission. Two patients who were planned for chemotherapy had deteriorated rapidly and succumbed to septicaemia from pancytopaenia. Subcutaneous panniculitic T-cell lymphoma has been reported to show two distinct clinical presentations. The first is characterized by an indolent course with good prognosis and the second with rapid clinical deterioration, haemophaegocytosis and death. Both presentations were seen in our five patients seem to demonstrate these two subtypes of SPTL.
    Matched MeSH terms: Skin Neoplasms/diagnosis*; Panniculitis/diagnosis*; Lymphoma, T-Cell, Cutaneous/diagnosis*
  12. Sukor N, Saidin R, Kamaruddin NA
    South. Med. J., 2007 Jan;100(1):73-4.
    PMID: 17269532
    Pheochromocytomas are rare neuroendocrine tumors that produce, metabolize, and usually secrete catecholamines. Although hypertension is a common presenting feature of pheochromocytoma, the tumors occur (or are present) in only 0.1% of patients with hypertension. The variability of symptoms and rarity of occurrence render these tumors difficult to diagnose; many are discovered incidentally during radiological examination or at autopsy. A patient is presented with a pheochromocytoma that was discovered incidentally when she presented with abdominal pain and a normal blood pressure.
    Matched MeSH terms: Adrenal Gland Neoplasms/diagnosis; Diagnosis, Differential; Pheochromocytoma/diagnosis
  13. Cheok CY, Merican A, Ng WM
    Med J Malaysia, 2006 Feb;61 Suppl A:97-9.
    PMID: 17042241
    We report a case of 20-year-old man who presented with bilateral femoral nerve palsy following resuscitation for traumatic massive blood loss and its consequence. A high suspicious index for this complication may lead to its early recognition. Its related pathoanatomy is discussed based on the described evidences in the literature. Nonoperative treatment remains as a recommended option for coagulopathy-related neuropathy.
    Matched MeSH terms: Disseminated Intravascular Coagulation/diagnosis; Paralysis/diagnosis; Femoral Neuropathy/diagnosis
  14. Zarina AL, Jamil MA, Ng SP, Rohana J, Yong SC, Salwati S, et al.
    Med J Malaysia, 2006 Jun;61(2):260-2.
    PMID: 16898328 MyJurnal
    Recurrent spontaneous abortion, defined as three consecutive abortions, occurs in approximately 1% to 2% of couples. Although the cause is unknown in up to 50% of cases, about 5% of these couples are found to be a balanced translocation carrier. We report a case in which the mother was identified to be a translocation carrier following the birth of a baby with multiple congenital abnormalities.
    Matched MeSH terms: Diagnosis, Differential; Monosomy/diagnosis; Trisomy/diagnosis
  15. Al-Jubouri MA, Inkster GD, Nee PA, Andrews FJ
    Ann. Clin. Biochem., 2006 Jul;43(Pt 4):323-5.
    PMID: 16824287 DOI: 10.1258/000456306777695681
    A 35-year-old Malaysian man presented with rapid onset of flaccid quadriparesis associated with nausea and vomiting. General blood tests revealed severe hypokalaemia (serum potassium 1.5 mmol/L) and hypophosphataemia (serum phosphate 0.29 mmol/L) as a potential cause of the flaccid paralysis. Arterial blood gases showed mixed acid base disturbance of respiratory alkalosis and metabolic acidosis with hyperlactataemia. Thyrotoxic periodic paralysis (TPP) was suspected as the underlying cause of this presentation and thyroid function tests showed severe hyperthyroid results (free T4 > 77.2 pmol/L, free T3 19.3 pmol/L, thyroid-stimulating hormone [TSH] < 0.05 mIU/L). Treatment with intravenous potassium and phosphate infusion and oral propranolol resulted in rapid resolution of his symptoms. A discussion of the clinical and pathophysiological features and treatment of TPP (a very rare encounter in UK clinical practice) is presented, and to our knowledge associated hyperlactataemia has not been previously described.
    Matched MeSH terms: Diagnosis, Differential; Thyrotoxicosis/diagnosis*; Hypokalemic Periodic Paralysis/diagnosis*
  16. Yusoff MS, Yaacob MJ, Naing NN, Esa AR
    Asian J Psychiatr, 2013 Feb;6(1):60-5.
    PMID: 23380320 DOI: 10.1016/j.ajp.2012.09.001
    This study evaluated the convergent, discriminant, construct, concurrent and discriminative validity of the Medical Student Wellbeing Index (MSWBI) as well as to evaluate its internal consistency and optimal cut-off total scores to detect at least moderate levels of general psychological distress, stress, anxiety and depression symptoms. A cross sectional study was done on 171 medical students. The MSWBI and DASS-21 were administered and returned immediately upon completion. Confirmatory factor analysis, reliability analysis, ROC analysis and Pearson correlation test were applied to assess psychometric properties of the MSWBI. A total of 168 (98.2%) medical students responded. The goodness of fit indices showed the MSWBI had a good construct (χ(2)=6.14, p=0.803, RMSEA<0.001, RMR=0.004, GFI=0.99, AGFI=0.97, CFI=1.00, IFI=1.02, TLI=1.04). The Cronbach's alpha value was 0.69 indicating an acceptable level of internal consistency. Pearson correlation coefficients and ROC analysis suggested each MSWBI's item showed adequate convergent and discriminant validity. Its optimal cut-off scores to detect at least moderate levels of general psychological distress, stress, anxiety, and depression were 1.5, 2.5, 1.5 and 2.5 respectively with sensitivity and specificity ranged from 62 to 80% and the areas under ROC curve ranged from 0.71 to 0.83. This study showed that the MSWBI had good level of psychometric properties. The MSWBI score more than 2 can be considered as having significant psychological distress. The MSWBI is a valid and reliable screening instrument to assess psychological distress of medical students.
    Matched MeSH terms: Anxiety Disorders/diagnosis*; Depressive Disorder/diagnosis*; Stress, Psychological/diagnosis*
  17. Nair SR, Tan LK, Mohd Ramli N, Lim SY, Rahmat K, Mohd Nor H
    Eur Radiol, 2013 Jun;23(6):1459-66.
    PMID: 23300042 DOI: 10.1007/s00330-012-2759-9
    OBJECTIVE: To develop a decision tree based on standard magnetic resonance imaging (MRI) and diffusion tensor imaging to differentiate multiple system atrophy (MSA) from Parkinson's disease (PD).

    METHODS: 3-T brain MRI and DTI (diffusion tensor imaging) were performed on 26 PD and 13 MSA patients. Regions of interest (ROIs) were the putamen, substantia nigra, pons, middle cerebellar peduncles (MCP) and cerebellum. Linear, volumetry and DTI (fractional anisotropy and mean diffusivity) were measured. A three-node decision tree was formulated, with design goals being 100 % specificity at node 1, 100 % sensitivity at node 2 and highest combined sensitivity and specificity at node 3.

    RESULTS: Nine parameters (mean width, fractional anisotropy (FA) and mean diffusivity (MD) of MCP; anteroposterior diameter of pons; cerebellar FA and volume; pons and mean putamen volume; mean FA substantia nigra compacta-rostral) showed statistically significant (P < 0.05) differences between MSA and PD with mean MCP width, anteroposterior diameter of pons and mean FA MCP chosen for the decision tree. Threshold values were 14.6 mm, 21.8 mm and 0.55, respectively. Overall performance of the decision tree was 92 % sensitivity, 96 % specificity, 92 % PPV and 96 % NPV. Twelve out of 13 MSA patients were accurately classified.

    CONCLUSION: Formation of the decision tree using these parameters was both descriptive and predictive in differentiating between MSA and PD.

    KEY POINTS: • Parkinson's disease and multiple system atrophy can be distinguished on MR imaging. • Combined conventional MRI and diffusion tensor imaging improves the accuracy of diagnosis. • A decision tree is descriptive and predictive in differentiating between clinical entities. • A decision tree can reliably differentiate Parkinson's disease from multiple system atrophy.

    Matched MeSH terms: Diagnosis, Differential; Parkinson Disease/diagnosis*; Multiple System Atrophy/diagnosis*
  18. Jin-Poi T, Shatriah I, Ng SL, Zurkurnai Y, Yunus R
    JAMA Ophthalmol, 2013 Feb;131(2):263-5.
    PMID: 23411903 DOI: 10.1001/jamaophthalmol.2013.587
    Matched MeSH terms: Blindness/diagnosis; Heart Defects, Congenital/diagnosis*; Retinal Artery Occlusion/diagnosis*
  19. Ng WM, Chan KY
    Med J Malaysia, 2004 Dec;59 Suppl F:69-71.
    PMID: 15941169
    We report a case of delayed diagnosis of tarsal tunnel syndrome caused by a ganglion arising from the talo-calcaneal joint. Unusually the symptoms were mainly due to the lateral planter nerve compression with a positive Tinel's sign. A surgical decompression was successful in relieving the dysaesthesia in spite of a 7 years history.
    Matched MeSH terms: Diagnosis, Differential; Tarsal Tunnel Syndrome/diagnosis; Ganglion Cysts/diagnosis
  20. Aminudin CA, Samsudin OC, Hyzan MY, Hamzaini AH, Zahiah M
    Med J Malaysia, 2004 Dec;59 Suppl F:57-9.
    PMID: 15941165
    We are reporting a case of a patient with a symptomatic intra-articular ganglion of the knee arising from infrapatellar fat pad. Plain radiograph and Magnetic Resonance (MR) images were correlated with arthroscopic examination and histological findings. The cyst was removed and post operatively patient regained full extension.
    Matched MeSH terms: Diagnosis, Differential
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