Spontaneous pneumothorax and pneumomediastinum is defined as presence of free air or gas in the pleural cav- ity and mediastinal structures respectively. Spontaneous pneumothorax seems to be associated with anatomical abnormalities such as subpleural blebs or bullae, however not for spontaneous pneumomediastinum which may developed without an apparent precipitating cause. Both usually may occur in young healthy adults without serious underlying lung disease. We report a case of spontaneous pneumothorax and pneumomediastinum after a trivial injury. He was initially presented with dyspnea after two weeks of initial trivial trauma. Chest radiograph showed left apical pneumothorax with pneumomediastinum with no evidence of rib fracture. His condition was deemed non-traumatic by surgical colleague, thus admitted to medical ward for observation and eventually discharged well.
Oesophageal perforation is a not uncommon condition, yet it carries a high mortality rate and has been observed as the most grievous trauma to the digestive tract. Common causes include iatrogenic instrumentation, foreign-body swallowing, and physical injury. This report highlighted a case of oesophageal perforation complicated by formation of proximal descending aorta pseudoaneurysm as a result of okra ingestion. The patient was successfully treated with conservative treatment. The possible mechanism of oesophageal rupture, diagnosis, treatment, and other complica- tion will be further discussed.
Necrotizing autoimmune myopathy (NAM) is considered a new subgroup of a rare autoimmune idiopathic inflam- matory myopathies. Classically, NAM presented with sub-acute onset of proximal muscle loss of power with raised creatinine kinase and characteristic muscle biopsy showing muscle necrosis and regeneration with little inflamma- tion. Statin use, connective tissue diseases, malignancy and HIV infection are the identified risk factors for NAM. The autoantibodies expected to be presented in NAM are anti-signal recognition particle (SRP) and anti-hydroxymethylgl- utaryl-coenzyme A reductase (anti-HMGCR) antibodies. In this article, we present three cases of NAM with different risk factors and autoantibodies which we believe to have impact on the clinical course and outcome of our patients
Sarcoidosis is characterized by formation of inflammatory granulomas affecting all over the body, with pulmonary predilection (1). Neurosarcoidosis is a rare but potentially dangerous manifestation of sarcoidosis. We report a case of disseminated sarcoidosis presenting with a neurological diagnostic dilemma. Worsening mediastinal lymphade- nopathy, together formation of lung and liver nodules making a sarcoidosis diagnosis favourable. Histology from these lesions showed non-caseating granulomatous inflammation. She was treated as a rare case of disseminated sarcoidosis. To date, there is no specific or clear guideline on the management of disseminated sarcoidosis.
Introduction: Malaysia is an intermediate tuberculosis burdened country as classified by WHO. There was a recent rise in TB incidence. Healthcare providers, especially in secondary or tertiary centers, were constantly exposed to TB infected patients, which is a hazard source for TB infection. Thus, assessment of behavior towards TB is paramount through knowledge, attitude, health-seeking practice, and stigma domains. Method: A cross-sectional survey was carried out between November 2014 and February 2015 among healthcare providers in Medical Department, Hos- pital Ampang. Data were analyzed using SPSS ver 21. Results: Despite overall good knowledge on TB, only 20% of the correspondence knew which patient’s population is at risk of TB infection. Almost all perceived TB as a health threat and willing to seek medical care if they developed TB symptoms. However, a small proportion (5.3%) will keep it a secret if they contracted TB. This is contrasted by the majority that perceived TB patients will not be accept- ed by the community. Conclusion: Knowledge and attitude towards TB was adequate within the healthcare providers in Medical Department, Hospital Ampang despite the presence of some knowledge gaps. However, there was high perceived stigma that needed to be addressed in order for them to deliver the best medical care.
Sarcomas usually frequented in the head and neck region of young adults. Trachea is a rare site, and due to scarce clinical data, its clinical outcome is unclear. We reported a case of 60-year old patient presented with progressive worsening shortness of breath, cough, and progressive worsening dysphagia. Computer tomography scan revealed extensive 2 lobulated soft tissue lesions within and surrounding the trachea at the T4 level. Rigid bronchoscopy with mass cryo-debulking was performed and ultimately synovial sarcoma was diagnosed. Shortness of breath was com- pletely relieved post-procedure.
Introduction:Tropical herbs are used as a medicine long before the introduction of modern medicine, especially by traditional healers. However, its’ scientific benefits are not widely investigated. There is a belief that the use of tradi-tional herbs potentially causing health deterioration due to its unknown mechanism of actions and interactions, and the nature of its unregulated processing as a health supplement. Parkia speciosa (local: petai) and Pithecellobium jir-inga (local: jering) are two tropical herbs from the Leguminosae family that are widely used raw as salads with many perceived health benefits and harms. We reviewed both species, looking into scientific pieces of evidence supporting the belief. Methods: The databases of MEDLINE, PubMed, EBSCOhost, and Google Scholars were systematically searched for both in vitro and in vivo effects of both species with no language restriction. Data were extracted using standardised fashioned. Results:P speciosa has pharmacological properties including antioxidant and anti-inflam-mation. It has shown to have antibacterial properties and glucose-lowering activity. P jiringa contains known an-tioxidant metabolites such as flavonoids, phenolics and terpenoids. It also contains antiangiogenic properties with potential use in retinopathy, cancer, and Rheumatoid arthritis. However, both herbs have potentially harmful effects which include liver injuries. Large consumption of P jiringa leads to acute kidney injury. Conclusion: Consumption of both P speciosa and P jiringa has medicinal properties as well as health harm. If taken as a supplement, rigorous clinical trials are needed to delineate benefit vs harm effect of both herbs.