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Fulltext Giant urethral calculus

Win T

Singapore Med J, 1994 Aug;35(4):414-5.
PMID: 7899907

This is a case report of a 56-year-old Malay male presenting with a giant urethral calculus. The stone measuring 70 X 50 X 40 mm and weighing 45 g was impacted in the posterior urethra. The giant urethral calculus was removed successfully through external urethrotomy.
Fulltext Strongyloides stercoralis induced bilateral blood stained pleural effusion in patient with recurrent Non-Hodgkin lymphoma

Win TT, Sitiasma H, Zeehaida M

Trop Biomed, 2011 Apr;28(1):64-7.
PMID: 21602770

Infections and mTalignancies are common causes of pleural effusion. Among infectious causes, hyperinfection syndrome of Strongyloides stercoralis may occur in immunosuppressive patient. A 62-year-old man, known case of Non-Hodgkin lymphoma (NHL) was presented with recurrent NHL stage IV and had undergone salvage chemotherapy. Patient subsequently developed pneumonia with bilateral pleural effusion and ascites. We reported rhabditiform larvae of S. stercoralis in pleural fluid of both lungs without infiltration by lymphoma cells. Stool for microscopic examination also revealed rhabditiform larvae of S. stercoralis. This patient was a known case of NHL receiving chemotherapy resulting in immunosuppression state. Although S. stercoralis infection is not very common compared to other parasitic infections, it is common in immunosuppressive patients and may present with hyperinfection. Therefore, awareness of this parasite should be kept in mind in immunosuppressive patients.
Primary mediastinal large B-cell lymphoma and its mimickers: a rare case report with literature review

Win TT, Kamaludin Z, Husin A

Malays J Pathol, 2016 Aug;38(2):153-7.
PMID: 27568673 MyJurnal

Primary mediastinal large B-cell lymphoma (PMLBL) is an uncommon non-Hodgkin lymphoma with a distinct clinicopathological entity in the WHO classification of lymphoid malignancies. It is known to originate from B-cells of the thymus. It mimics thymic neoplasms and other lymphomas clinically and histopathologically. We reported a 33-year-old obese man who presented with shortness of breath off and on for 4 years. Radiologically, there was a huge anterior mediastinal mass. Tru-cut biopsy was initially diagnosed as type-A thymoma. Histopathological examination of the excised specimen revealed PMLBL with stromal fibrosis and sclerosis which created a diagnostic difficulty. The neoplastic cells varied from medium-sized to large pleomorphic cells, including mononuclear cells with centroblastic and immunoblastic features as well as bi-lobed Reed Sternberg (RS)-like cells and horse-shoe like hallmark cells. Some interlacing spindle cells and epithelioid cells were also present. Immunohistochemically, tumour cells expressed diffuse positivity for LCA, CD20, CD79a, CD23, Bcl2, MUM-1 and heterogenous positivity for CD30 and EMA, and were negative for CD10, CD15 and ALK. Ki67 scoring was very high. Tumour cells infiltrated into peri-thymic fat and pericardium. No malignant cells were detected in the pleural fluid and there was no bone marrow infiltration. The patient showed partial response to 6 cycles of RICE chemotherapy, and was planned for second line chemotherapy using hyper-CVAD regimen followed by autologous stem cell transplantation. This case illustrates the importance of thorough sampling and immunohistochemistry in differentiating PMLBL from its differential diagnoses.
Fulltext Synthesis of nanopartical-based binary oxide electrode tio2-zro2 with carrot-derived natural dye extract for dye sensitized solar cell (DSSC) application

Win, S. Y., Win, T. T., Maung, Y. M., Soe, K. K. K., Kyaw, T. T., Tan, C. K., et al.

Pertanika Journal of Science & Technology, 2015;23(1):119-125.
MyJurnal

Dye-sensitized solar cell (DSSC) is the third generation of thin film solar cell. In this work, carrot fruit dye was prepared and used in DSSC as a sensitizer. TiO2–ZrO2 fine binary oxide was mechanochemically prepared and made paste. TiO2–ZrO2 paste (colloidal) was deposited onto FTO/glass in two ways, i.e. as single and double coatings by rolling method. It was immersed in the carrot solution to get dyed cell. The dyed TiO2-ZrO2-FTO/glass cell was offset with the FTO/glass cell coated with adhesive carbon paste. Photovoltaic properties of prepared TiO2–ZrO2 DSSC cell were measured. Results showed that the efficiency of double coating cell was greater than that of the single coating cell. According to the fill factor from the experiments, both the DSSC cells were acceptable for industrial requirement. Hence, it can be concluded that the results obtained were acceptable in the use of cost-effective and eco-favourable dye-sensitized solar cell.
Palm Olein Emulsion: a Novel Vehicle for Topical Drug Delivery of Betamethasone 17-Valerate

Ahmad K, Win T, Jaffri JM, Edueng K, Taher M

AAPS PharmSciTech, 2018 Jan;19(1):371-383.
PMID: 28744617 DOI: 10.1208/s12249-017-0843-9

This study aims to investigate the use of palm olein as the oil phase for betamethasone 17-valerate (BV) emulsions. The physicochemical properties of the formulations were characterized. In vitro drug release study was performed with the Hanson Vertical Diffusion Cell System; the samples were quantified with HPLC and the results were compared with commercial products. Optimized emulsion formulations were subjected to stability studies for 3 months at temperatures of 4, 25, and 40°C; the betamethasone 17-valerate content was analyzed using HPLC. The formulations produced mean particle size of 2-4 μm, viscosities of 50-250 mPa.s, and zeta potential between -45 and -68 mV. The rheological analyses showed that the emulsions exhibited pseudoplastic and viscoelastic behavior. The in vitro release of BV from palm olein emulsion through cellulose acetate was 4.5 times higher than that of commercial products and more BV molecules deposited in rat skin. Less than 4% of the drug was degraded in the formulations during the 3-month period when they were subjected to the three different temperatures. These findings indicate that palm olein-in-water emulsion can be an alternative vehicle for topical drug delivery system with superior permeability.
Clinicopathological study of gastric cancer in a Malaysian tertiary public health care centre

Htet H, Win TT, Wong ST, Shamsudin NH, Kandasami P

Med J Malaysia, 2023 Sep;78(5):616-620.
PMID: 37775488

INTRODUCTION: Gastric cancer (GC) is one of the leading causes of all new cancer cases globally. Although it is no longer reported in the top 10th most common cancer in Malaysia, geographical distribution and ethnic influences still obviously exist.
MATERIALS AND METHODS: This is a retrospective analysis of histopathological records in a public tertiary health care centre in Malaysia. The computerised laboratory information system from the histopathology department of the hospital was retrieved for the period of 2005-2018. Descriptive analysis was done using Microsoft Excel.
RESULTS: There was a total of 233 histologically confirmed GC cases. The burden of GC was observed to be an increasing trend from 2016 onwards. Among them, 64% were male and 36% were female. The youngest age of diagnosis was 19, while the oldest one was 93. Malaysian Chinese were found to have the highest incidences (41.63%), followed by Malays (32.19%) and Malaysian Indians (23.61%). All cases were of adenocarcinoma cell types and were found to have poorly differentiated in majority at the time of diagnosis.
CONCLUSION: Although this report only represents one tertiary health care centre in Malaysia, the Indian Enigma was still observed, as stated in other literatures. Over time, the incidence of GC in Malays has increased. Consideration of lifestyle modifications, health education and Helicobacter pylori eradication in various nations' National Health Insurance plans, are encouraged as prevention is always better than treatment or cure, including the cost load.
A 5-year clinicopathological study on microscopic colitis at a Malaysian tertiary hospital

Abdul Hafidz MI, Zulkifli KK, Win TT, Mat Zin AA, Mustaffa N

Med J Malaysia, 2021 05;76(3):318-325.
PMID: 34031329

INTRODUCTION: Microscopic colitis (MC) is a well-recognised cause of chronic diarrhoea in Western countries. It is classically associated with normal endoscopic findings and a higher prevalence among patients with autoimmune disease. Local information regarding this disease remains scarce. We identified patients diagnosed with MC over a five-year period, and then proceeded to analyse the clinical characteristics of these cases.
MATERIALS AND METHODS: A retrospective study was conducted by identifying all histologically confirmed colitis cases diagnosed at Hospital Universiti Sains Malaysia from January 2015 until December 2019. Clinicodemographic data was retrieved from case notes of patients.
RESULTS: Of the 299 cases with histological colitis, 23 (7.7%) were initially identified as MC. Two cases had incomplete data, while two others were excluded as the diagnoses were revised to inflammatory bowel disease. An incidence of 14 MC cases/1000 case-year was obtained using the 21 MC cases seen within the five-year period. MC subtypes for the 19 analysed cases i.e., lymphocytic colitis and collagenous colitis accounted for 13 (68.4%) and 6 (31.6%) cases, respectively. Eleven patients (57.9%) were females (M:F ratio 1:1.5) with a median age of 51 years. Only nine (47.3%) presented with diarrhoea; one subject (5.4%) had an autoimmune condition (Hashimoto thyroiditis). Normal endoscopic findings were found in 89.5% of patients.
CONCLUSION: Approximately half of the subjects in our study who had histologically confirmed MC did not present with diarrhoea. Adequate biopsy samples despite normal colonoscopy findings are important in order to not miss the diagnosis of MC.
Subclinical Hypothyroidism and Clinical Outcomes After Percutaneous Coronary Intervention: A Meta-Analysis

Ang SP, Chia JE, Jaiswal V, Bandyopadhyay D, Iglesias J, Mohan GVK, et al.

Curr Probl Cardiol, 2023 Aug;48(8):101719.
PMID: 36967069 DOI: 10.1016/j.cpcardiol.2023.101719

While subclinical hypothyroidism (SCH) was reportedly associated with an increased risk of cardiovascular mortality, the relationship between SCH and clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) is uncertain. The aim of this study was to assess the association of SCH and cardiovascular outcomes in patients undergoing PCI. We searched PubMed, Embase, Scopus, and CENTRAL databases from its inception until April 1, 2022 for studies comparing the outcomes between SCH and euthyroid patients undergoing PCI. Outcomes of interest include cardiovascular mortality, all-cause mortality, myocardial infarction (MI), major adverse cardiovascular and cerebrovascular events (MACCE), repeat revascularization and heart failure. Outcomes were pooled using the DerSimonian and Laird random-effects model and reported as risk ratios (RR) and 95% confidence intervals (CI). A total of 7 studies involving 1132 patients with SCH and 11,753 euthyroid patients were included in the analysis. Compared with euthyroid patients, patients with SCH had significantly higher risk of cardiovascular mortality (RR 2.16, 95% CI: 1.38-3.38, P < 0.001), all-cause mortality (RR 1.68, 95% CI: 1.23-2.29, P = 0.001) and repeat revascularization (RR 1.96, 95% CI: 1.08-3.58, P = 0.03). However, there were no differences between both groups in terms of incidence of MI (RR 1.81, 95% CI: 0.97-3.37, P = 0.06), MACCE (RR 2.24, 95% CI: 0.55-9.08, P = 0.26) and heart failure (RR 5.38, 95% CI: 0.28-102.35, P = 0.26). Our analysis suggests among patients undergoing PCI, SCH was associated with increased risk of cardiovascular mortality, all-cause mortality and repeat revascularization compared to euthyroid patients.