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Fulltext Splenic amyloidosis: a rare cause of spontaneous splenic rupture

Chan RS, Abdul Aziz YF, Chandran P, Ng EK

Singapore Med J, 2011 Nov;52(11):e232-5.
PMID: 22173263

A 62 year-old woman who presented with an atraumatic acute abdomen was discovered to have haemoperitoneum with splenic rupture on urgent computed tomography and was immediately referred for life-saving emergency splenectomy. Histopathological examination revealed secondary splenic amyloidosis. The patient was later found to be suffering from infective endocarditis secondary to her permanent cardiac pacemaker. This report describes a patient who could have suffered from a long-standing infected vegetation on a permanent cardiac pacemaker, which led to splenic amyloidosis and spontaneous splenic rupture.
Metastatic leiomyosarcoma of the thyroid: A rare entity

Che Jalil NA, Rama Chandran P, Samsudin AHZ, Yahya MM, Wan Abdul Rahman WF

Malays J Pathol, 2021 Apr;43(1):69-73.
PMID: 33903308

Cancer metastasis to the thyroid gland from non-thyroid sites is a rare presentation in clinical practice. The most frequent primary cancers that metastasise to the thyroid are renal cell carcinoma, followed by colorectal, lung and breast. We report a case of a 64-year-old Malay lady who presented with anterior neck swelling 4 years after an initial diagnosis of uterine leiomyosarcoma. She had undergone a hysterectomy procedure four years ago. Fine needle aspiration cytology of the thyroid mass suggested undifferentiated thyroid carcinoma. After multi-disciplinary discussion, the patient underwent thyroidectomy and the final histopathological diagnosis was metastatic leiomyosarcoma of the thyroid. The diagnosis was aided by an immunohistochemistry panel of positive myogenic markers, negative epithelial markers as well as the previous medical history of uterine leiomyosarcoma. Metastatic leiomyosarcoma of the thyroid may mimic primary undifferentiated (anaplastic) thyroid carcinoma (UTC) with a sarcomatoid pattern, medullary thyroid carcinoma (MTC) with spindle cells morphology and spindle cell tumour with thymus-like differentiation (SETTLE). Hence, a multidisciplinary approach must be practised by pathologists, surgeons and radiologists to consider metastatic lesions of the thyroid gland, especially when a previous history of cancer exists or is suspected.
Adoption of digital twin for sustainable manufacturing and achievements of production strategic-planned goals

Jawad MS, Chandran P, Ramli AAB, Mahdin HB, Abdullah ZB, Rejab MBM

MethodsX, 2022;9:101920.
PMID: 36420313 DOI: 10.1016/j.mex.2022.101920

To achieve the maximum return-of-investment for the adoption of Digital-Twin in manufacturing, organizations should be totally aware about the challenges that limit the widely adoption as well as opportunities that may create real-added values to their businesses at operational and strategic management. In this context, determining the most influential factors for successful adoption must be clear even at the early stages of planning towards high effective digital-transformation journey for business's sustainability. The beneficial achievements and outcome towards such successful planning and adoption of the industrial digital-twin are significant in terms of optimized processes, reduced costs and downtown of the operations, flexibility in product design and processes' adaptation to satisfy future markets demands The main purpose of this paper is to propose adoption modelling of digital-twin for optimized products and production processes. The methodology of the proposed modelling can be considered unique in the following aspects of:•Determining the expected added-values of adopting digital-twin to the manufacturing business according to certain business's operational criticality, budget and size.•Allowing processes' optimization at three levels of plant (factory) physical layout, Machines' operational fault tolerance and final products' design and quality.•Allowing strategic-planning achievement for sustainable Production-Product and future demands.
Fulltext Distinctive Clinico-Pathological Characteristics of Colorectal Cancer in Sabahan Indigenous Populations

Valan A, Najid F, Chandran P, Abd Rahim AB, Chuah JA, Roslani AC

Asian Pac J Cancer Prev, 2021 Mar 01;22(3):749-755.
PMID: 33773538 DOI: 10.31557/APJCP.2021.22.3.749

BACKGROUND: Malaysia is an ethnically diverse nation, comprising Malay, Chinese, Indian and indigenous groups. However, epidemiological studies on colorectal cancer have mainly focused on the three main ethnic groups. There is evidence that the clinico-pathological characteristics of some cancers may differ in indigenous populations, namely that they occur earlier and behave more aggressively. We aimed to determine if there were similar differences in colorectal cancer, focusing on the indigenous populations of Sabah.
METHODS: Histopathological reports of all patients diagnosed with colorectal carcinoma from January 2012 to December 2016 from public hospitals in Sabah were retrieved from the central computerized database of the Pathology Department of Queen Elizabeth Hospital in Kota Kinabalu, Sabah. Supplementary data was obtained from patients' case files from each hospital. Clinico-pathological data were analysed using the IBM SPSS Statistical Software Version 23 for Windows for descriptive statistics (mean, median, ASR, AR, relative risk) and inferential statistics (Chi square test).
RESULTS: A total of 696 patients met the inclusion criteria. The median age for colorectal cancer in Sabah was 62 years (95% CI 60.3 to 62.3), with an age specific incidence rate of 21.4 per 100 000 population. The age specific incidence rate in the indigenous populations was 26.6 per 100 000, much lower than the Chinese, at 65.0 per 100 000. The risk of colorectal cancer occurring before the age of 50 was three times higher in the indigenous population compared to the Chinese. The tumours were mainly left-sided (56.5%), adenocarcinoma in histology (98.4%) and moderately differentiated (88.7%). Approximately 79.2% of patients received curative treatment.
CONCLUSION: Indigenous populations in Sabah develop colorectal cancer at an earlier age, and present at more advanced stages. This has implications for screening and therapeutic strategic planning.
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