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Fulltext Therapeutic drug monitoring of gentamicin in patients with bronchopneumonia: cost considerations and patient outcomes

Ahmed Abdelrahim HE, Ab Rahman AF, Mohamed Ibrahim MI

Eurasian J Med, 2012 Apr;44(1):1-5.
PMID: 25610196 DOI: 10.5152/eajm.2012.01

In Malaysia, therapeutic drug monitoring (TDM) service started in the late 1980s. Serum concentration measurements depend on commercially available drug assays, which are costly. In the present study, we attempted to document the impact of TDM service on cost and patient outcomes.
Fulltext A Rare Presentation of Anterior Mediastinal Teratoma Mimicking Valvular Heart Disease with A Systolic Murmur

Lip HTC, Huei TJ, Wahid AA, Vendargon SJ

Eurasian J Med, 2018 Jun;50(2):134-136.
PMID: 30002584 DOI: 10.5152/eurasianjmed.2018.17388

Extrinsic pulmonary artery stenosis caused by anterior mediastinum teratoma presenting with an ejection systolic murmur is a rare phenomenon. Till date, 15 cases have been reported (inclusive of this case) in the English literatures. Herein we report a 20 year old female with extrinsic pulmonary artery stenosis because of compression by an anterior mediastinal teratoma with a loud ejection systolic murmur. The case report aims to highlight the awareness of such rare presentation of anterior mediastinal teratomas that may mimic congenital valvular heart diseases among clinicians.
Fulltext Suture Granuloma 14 Years Following Partial Thyroidectomy Masquerading as Tuberculosis af The Sinus Tract

Abdul Hamid MF, Yu-Lin AB, Maharani Hassan T

Eurasian J Med, 2018 Jun;50(2):122-124.
PMID: 30002580 DOI: 10.5152/eurasianjmed.2018.0006

Suture granuloma rarely occurs after thyroid surgery using non-absorbable sutures. We report the case of a 63-year-old female with a chronic discharging sinus in the anterior neck region. She had a history of subtotal thyroidectomy at the age of 45. The sinus had been excised and was reported as granulomatous lesions suggestive of tuberculosis. She was treated with anti-tuberculous medications, but unfortunately, she developed side effects. Histopathological slides were re-evaluated, which showed evidence of foreign material under polarized light; hence, the diagnosis was revised to suture granuloma. In conclusion, although sinus tract discharges are commonly attributed to tuberculosis, physicians should consider suture granuloma if they encounter a patient who has undergone a surgical procedure in the past.
Fulltext Factors Associated with Good Seizure Control in Patients on Valproic Acid

Ahmad M, Rahman AFA, Sapuan S

Eurasian J Med, 2020 Feb;52(1):41-46.
PMID: 32158313 DOI: 10.5152/eurasianjmed.2020.19039

Objective: This study aims to generate a reference range for valproic acid (VPA) in this cohort and determine the factors associated with good seizure control in patients taking this drug.
Materials and Methods: We conducted a prospective, cohort, observational study among patients with epilepsy who received VPA treatment at Hospital Kuala Lumpur. The patients were considered to have good control if they had a 50% or higher seizure reduction in the one-year study period compared with the previous year. The VPA reference range was generated from those patients who had good control and whose drug concentration values were available. Multiple logistic regression analysis with a backward likelihood ratio method was applied to assess the predicting factors for good seizure control.
Results: A total of 242 patients were recruited and followed up for one year. The VPA reference range was determined to be 40-85 mg/L. After multivariate analysis, significant predictive variables for good control were monotherapy [adjusted OR 4.74, 95% CI: 2.258, 9.947, p<0.001], non-smoking [adjusted OR 3.23, 95% CI: 1.099, 9.473, p=0.033], normal brain imaging results [adjusted OR 5.83, 95% CI: 2.507, 13.552, p<0.001], and the absence of stress [adjusted OR 19.98, 95% CI: 9.255, 42.764, p<0.001].
Conclusion: Monotherapy, non-smoking, normal brain imaging results, and the absence of stress are predictive of good seizure control in patients on VPA. However, a serum concentration of VPA in the reference range failed to predict good seizure control.
Fulltext Training Induced Oxidative Stress-Derived DNA and Muscle Damage in Triathletes

Zainudin H, Caszo BA, Knight VF, Gnanou JV

Eurasian J Med, 2019 Jun;51(2):116-120.
PMID: 31258349 DOI: 10.5152/eurasianjmed.2019.18106

Objective: Regular moderate-intensity exercise has beneficial health effects, whereas regular strenuous exercise increases the production of oxidants that may lead to DNA, skeletal, and cardiac muscle damages. Triathletes experience strenuous muscular activity both during competition and training, being at risk of developing these tissue damages. The objective of the present study was to estimate DNA, skeletal, and cardiac muscle damages using blood biomarkers, 8-hydroxy-2'-deoxyguanosine (8-OHdG), myoglobin, and cardiac troponin I (cTnI) among young triathletes.
Materials and Methods: Age-matched seven male and seven female triathletes were recruited for the study. They were on a standardized training regimen and on average competed in at least one endurance event every month for the past 3-4 years. Serum biomarkers were measured using enzyme-linked immunosorbent assay at the start and at end of the racing season.
Results: Both male and female triathletes showed a statistically significant increase in 8-OHdG. A similar pattern of increase was seen with serum myoglobin, which was not statistically significant in both male and female triathletes. cTnI levels did not show any change in both sexes.
Conclusion: Our study shows that there could be an increased evidence of DNA damage among triathletes. However, similar effects were not observed with skeletal and cardiac muscle biomarkers.
Fulltext The Utility of [18]F-Fluorocholine Positron Emission Computed Tomography and [18]F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in Evaluating Breast Cancer Phenotypes: A Pilot Study

Zakaria MH, Shaharudin S, Ahmad Saad FF

Eurasian J Med, 2024 Apr 18;56(2):78-85.
PMID: 39145500 DOI: 10.5152/eurasianjmed.2024.23047

The utility of the [18]F fluorodeoxyglucose positron emission tomography-computed tomography ([18]F FDG PET-CT) marker for breast cancer is well established. Given its limitations in localizing FDG-negative malignant tumors, the expression of [18]F-fluorocholine ([18]-FCH) may potentially be helpful to improve the overall accuracy in evaluating breast cancer. This study determined the potential of [18]- FCH PET CT as a potential marker in assessing breast cancer phenotypes. We recruited consecutive patients with biopsy-proven breast carcinoma who underwent [18] F-FCH PET-CT following the [18]F-FDG PET-CT imaging. The subjects were dichotomized into human epidermal growth factor receptor 2 (HER2)-negative and HER2-positive genotypes. The maximum standardized uptake value (SUVmax; g/dL) was used to predict the two groups of variables. Global health status (GHS) score based on the EORTC quality of life questionnaire (QLQ) was used to evaluate the outcome of the cohort subjects at 6, 12, and 24 months. There were 21 females with a mean age of 54.48 ± 12.17 years. Eighteen patients had invasive ductal carcinoma (18/21;85.8%) on histology, with 11 (52.4%) were HER2-negative genotype. There was higher sensitivity and specificity of [18]-FCH-PET/CT in breast lesions at 40% and 68.8% compared to [18]FDGPET/CT with 33.3% and 66.7%, respectively. There were significant differences between [18]F-FCH SUVmax (g/dL) of the HER-negative as compared to the HER2- positive group (1.99 g/dL vs. 0.2 g/dL; P < .05). High SUVmax (g/dL) of [18]F-FCH had predicted the HER-negative genotype at the cutoff value of 0.75 (P < .05). High [18]F-FCH showed significantly poor scoring of GHS parameters compared to low FCH at 6 months (mean SUVmax 8.06 vs. 5.40 respectively; P < .05). [18]F-FCH PET-CT is a potential marker in localizing and predicting aggressive breast carcinoma phenotypes.
Fulltext Diffusion Tensor Imaging in Determining Atypical Peripheral Nerve Neuroma in a Patient with a Painless Mass

Saad FFA, Fikri RSF, Shahrir ADA

Eurasian J Med, 2024 May 09;56(2):146-7.
PMID: 38798009 DOI: 10.5152/eurasianjmed.2024.23149

Cite this article as: Fikri Ahmad Saad F, Syamim Fathinul Fikri R, Danial Ahmad Shahrir A. Diffusion tensor imaging in determining atypical peripheral nerve neuroma in a patient with a painless mass. Eurasian J Med., Published online May 9, 2024. doi:10.5152/eurasianjmed.2024.23149.