MyMedR

Dermatomyositis and nasopharyngeal carcinoma

Low QJ, Hon SA, Garry Siow PW, Lim TH, Lee RA, Tan YA, et al.

QJM, 2020 Oct 01;113(10):753-754.

PMID: 31995198 DOI: 10.1093/qjmed/hcaa014

Knowledge, attitude, practice and perception on sunscreen and skin cancer among doctors and pharmacists

Low QJ, Teo KZ, Lim TH, Cheo SW, Yap WYE

Med J Malaysia, 2021 03;76(2):212-217.

INTRODUCTION: Excessive ultraviolet light (UV) can cause premature skin aging and potentially skin cancer. Currently there is a lack of awareness among health care professionals and the public on sun protection. The objectives of this study were to determine knowledge on sunscreen and skin cancer among health care professionals, to evaluate the knowledge, attitude, practice and perception of doctors and pharmacists toward the usage of sunscreen as protection against UV radiation.

MATERIALS AND METHODS: This is a cross-sectional study conducted among doctors and pharmacists in Hospital Sultanah Nora Ismail, Batu Pahat, Johor, Malaysia. Questionnaires were used in this study.

RESULTS: A total of 384 participants completed the questionnaires. The participants consisted of 323 doctors (84.1%) and 61 pharmacists (15.9%). The age group of the participants ranged between 25 till 55 years old. Ninety doctors (27.9%) and thirty-one pharmacists (51.0%) reported used sunscreen daily (p<0.001). This finding showed that there was a deficit in the practice of sun protection. Pharmacists scored a higher knowledge score of median 12 (IQR=3.0) while the doctors scored 11 (IQR=2.0). This study showed a significant association between ethnicity and skin cancer knowledge (p<0.05).

CONCLUSION: This study demonstrated a lack of knowledge of sunscreen and skin cancer prevention among health care practitioners. This finding supports better medical education program on this topic.

A case of Takayasu Arteritis presenting with young stroke

Cheo SW, Mohd Zamin H, Low QJ, Tan YA, Chia YK

Med J Malaysia, 2020 11;75(6):745-747.

PMID: 33219190

Stroke is a debilitating disease as it carries significant morbidity especially when it affects the younger population. There are various etiologies of young stroke, namely arterial dissection, cardioembolism, thrombophilia, inherited genetic disorder and vasculitis. Young patient with stroke should undergo complete evaluation to identify the underlying etiology in order to prevent recurrence of stroke. Here, we would like to illustrate a case of Takayasu arteritis presenting as young stroke in a 17-years-old lady with no known medical illness.

A Case of Severe Falciparum Malaria in a Returned Traveler

Low QJ, Lau WK, Lim TH, Lee RA, Cheo SW

Malays Fam Physician, 2020;15(3):86-89.

PMID: 33329868

Primary care providers should be alert to travel-related infections. Around 10-40% of returning travelers from all destinations and 15-70% of travelers from tropical settings experience ill health, either overseas or upon returning home.1 A systematic approach concentrating on possible infections should be undertaken based on the patient's travel location, immunization history, presence of malaria chemoprophylaxis at the destination, other potential exposures, incubation period, and clinical presentation.2-3 The World Health Organization (WHO) website is constantly being updated on specific travel-related infections and recent geographical outbreaks. In this paper, we report a case of severe falciparum malaria in a returned traveler.

Primary splenic hodgkin lymphoma masquerading as splenic abscess

Khoo TT, Cheo SW, Low QJ, Tan YA, Wong LLL

Med J Malaysia, 2021 Jan;76(1):118-120.

PMID: 33510123

Hodgkin lymphoma is a form of malignant lymphoid neoplasm. It can have various clinical presentations such as prolonged fever, night sweats, weight loss and asymptomatic lymphadenopathy. It has a distinct fever pattern known as Pel Ebstein fever. However, in some instances, its clinical presentation can mimic some tropical infections. Here, we present a case of primary splenic lymphoma masquerading as splenic abscess in a 53-yearold man with underlying dyslipidemia.

Fatal subarachnoid haemorrhage in a patient with severe dengue

Cheo SW, Low QJ, Ng EK, Chia YK, Rajahram GS

Med J Malaysia, 2021 Jan;76(1):107-109.

PMID: 33510120

Dengue fever is one of the commonest tropical disease in the tropics. It can present with mild acute febrile illness to severe organ failure. Reported neurological complications of dengue include dengue encephalopathy, encephalitis, transverse myelitis and intracranial haemorrhage. Intracranial haemorrhage in dengue can present as subdural haematoma, extradural haematoma, intracerebral haemorrhage and subarachnoid haemorrhage. We report here a case of subarachnoid haemorrhage in a patient with severe dengue. Our patient was a 30-year-old man who presented with acute febrile illness. He subsequently developed plasma leakage and upper gastrointestinal bleeding. He then had reduced conscious level. Computed tomography of his brain showed subarachnoid haemorrhage. He eventually succumbed to his illness.

Erysipelothrix rhusiopathiae endocarditis presenting with stroke

Tan YA, Ng KC, Cheo SW, Low QJ, Chia YK

QJM, 2020 07 01;113(7):485-487.

PMID: 32053172 DOI: 10.1093/qjmed/hcaa025

A case of arrhythmogenic right ventricular cardiomyopathy with right ventricle thrombus: A case report

Low QJ, Siaw C, Cheo SW, Kim HS, Benjamin Leo CL, Norliza O, et al.

Med J Malaysia, 2020 07;75(4):452-454.

PMID: 32724017

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare inherited cardiomyopathy characterised by right ventricular dysfunction, ventricular arrhythmias and increased risk of sudden cardiac death. Due to the replacement of myocardium with fibro-fatty and fibrous tissue, patients with ARVC are prone to develop ventricular tachycardia. Histologically, it is often reported as the 'triangle of dysplasia' involving the inflow tract, outflow tract and apex of the right ventricle.2 We describe a 20-years-old patient who collapsed during a futsal match and was subsequently diagnosed to have ARVC with a right ventricular thrombus from cardiac magnetic resonance imaging.

Dilemma in the management of methanol poisoning at a district hospital in Malaysia

Low QJ, Lee KT, Lim TH, Siaw C, Cheo SW, Tan NE, et al.

Med J Malaysia, 2020 07;75(4):442-444.

PMID: 32724013

There are increasing reports of methanol poisoning (MP) incidence worldwide. In Malaysia, the largest first methanol poisoning was reported in Selangor in 2013 with a total of 41 patients and cluster of cases been reported from the country since then. Often MP involved adulterated alcohol containing more than the legal permissible concentration of methanol. Methanol is rapidly absorbed and metabolised into formic acid which causes variable symptoms of the central nervous system such as blindness, seizure, coma and gastrointestinal disturbances. Mortality could reach up to 83% as reported using the coma state, pH and pCO2 level in the worst-case scenario.

A case of severe Plasmodium knowlesi malaria in a post-splenectomy patient

Cheo SW, Khoo TT, Tan YA, Yeoh WC, Low QJ

Med J Malaysia, 2020 07;75(4):447-449.

PMID: 32724015

Malaria is a parasitic disease that is caused by the Plasmodium parasite. Worldwide, it remains a significant public health problem especially in the Africa region where it contributes to more than 90% of cases and malaria death. However, zoonotic (simian) Plasmodium knowlesi parasite is a widely prevalent cause of malaria in the South East Asian countries. It is known to cause severe human disease due to its 24hour erythrocytic cycles. Thus far, cases of severe falciparum malaria have been reported in asplenic patients. Here, we report a case of severe P.knowlesi malaria in a 51-year-old man who is a postsplenectomy patient.

Interstitial pneumonia with autoimmune features

Low QJ, Teo KZ, Thien LK, Lim TH, Cheo SW

J R Coll Physicians Edinb, 2020 12;50(4):387-391.

PMID: 33469613 DOI: 10.4997/JRCPE.2020.407

BACKGROUND: Cardiac tamponade is a medical emergency. This study was carried out to determine the etiologies of cardiac tamponade and review the management and outcomes.

METHODS: We retrospectively analysed case records of patients who underwent pericardiocentesis for cardiac tamponade during the two consecutive years (1 January 2018 to 31 December 2019) at Hospital Sultanah Nora Ismail, Batu Pahat, in Johor, Malaysia.

RESULTS: There were ten patients (eight males, two females; age range 20 to 70 years old, mean age 36 years old) who underwent pericardiocentesis for cardiac tamponade during the said period. Malignancy (40%), tuberculosis (30%), idiopathic (20%), and bacterial (10%) were among the common causes of the pericardial effusion in this center. The commonest symptoms were breathlessness (90%), chest pain (60%), cough (50%), and unexplained fever (20%). Pulsus paradoxus was the most speciÿ c sign (100%) for the presence of echocardiographic feature of cardiac tamponade. Two of the patients with tuberculous pericarditis had retroviral disease; one patient had bacterial pericarditis due to salmonella typhi.

CONCLUSION: This study has conÿ rmed that there are many etiologies and presentation of cardiac tamponade; clinicians should be alert as urgent pericardiocentesis is lifesaving.

Familial neuromyelitis optica spectrum disorder in a pair of sisters

Cheo SW, Ong SAM, Low QJ, Tan YA, Chia YK

QJM, 2020 Oct 01;113(10):743-746.

PMID: 32240316 DOI: 10.1093/qjmed/hcaa107

Immune reconstitution inflammatory syndrome and human immunodeficiency virus infection

Cheo SW, Ahmad Akbar RZ, Abd Rahman F, Abdul Rashid WNF', Tan YA, Low QJ

QJM, 2020 Nov 01;113(11):809-812.

PMID: 32275748 DOI: 10.1093/qjmed/hcaa122

Case series of haemothorax secondary to avulsed bullae vessel

Low QJ, Hatta Z, Cheo SW, Syed RSH, Goh KS

Med J Malaysia, 2019 Oct;74(5):431-432.

PMID: 31649221

Haemothorax refer to the bleeding in the pleural space. It is commonly due to iatrogenic, blunt or penetrating chest trauma. Non-traumatic haemothorax is a rare entity that can potentially lead to life threatening complications. The initial management of both traumatic and non-traumatic haemothorax includes resuscitation and stabilisation of the patient. We would like to present two cases of non-traumatic haemothorax secondary to an avulsed bullae vessel.

Response to: Stroke and infective endocarditis

Tan YA, Ng KC, Cheo SW, Low QJ, Chia YK

QJM, 2020 07 01;113(7):517-518.

PMID: 32191336 DOI: 10.1093/qjmed/hcaa099

Acute necrotizing encephalopathy in a child secondary to dengue fever: A case report

Cheo SW, Low QJ, Teh YG, Rajahram GS, Mohd Zain NR, Chia YK

Med J Malaysia, 2021 Sep;76(5):750-752.

PMID: 34508389

Dengue fever (DF) is an important public health problem, and it is now endemic in more than 100 countries worldwide. Dengue associated neurological complication is estimated to be affecting 0.5 to 6.2% of patients. Even though this is rare, neurological manifestation of DF is an increasingly recognized entity in recent years due to significant mortality and morbidity reported/seen. Reported central nervous system manifestations due to dengue include encephalitis, encephalopathy, myelitis, myositis, acute disseminated encephalomyelitis, Guillain-Barré syndrome, stroke and etc. We report here a case of acute necrotizing encephalopathy secondary to DF in a previously healthy 12-year-old girl.

Fulltext Posterior reversible encephalopathy syndrome secondary to dengue fever: a case report

Cheo SW, Wong HJ, Ng EK, Low QJ, Chia YK

Hong Kong Med J, 2021 02;27(1):55-57.

PMID: 33568560 DOI: 10.12809/hkmj208509

Fulltext Erythematous plaques of the vulvo-perineal region

Low QJ, Lim TH, Hon SA, Cheo SW, Wagino N, Yap EWL

Malays Fam Physician, 2021 Nov 30;16(3):101-103.

PMID: 34938398 DOI: 10.51866/cr1276

Skin conditions are a common reason for consulting primary health care. The public frequently expects their primary health care providers to be able to recognise and treat common skin conditions with confidence. Primary care providers must be able to identify 'red flag' skin conditions that require dermatology referral. However, diagnosis is often delayed due to the non-specific clinical presentation, low incidence, slow evolution and long-term history of such lesions. We report the case of a patient with extramammary Paget's disease that presented to her primary care provider and subsequently underwent a wide local excision.

Fulltext Haemophagocytic lymphohistiocytosis secondary to dengue fever: a case report

Cheo SW, Abdul Rashid WNFA, Ho CV, Ahmad Akhbar RZ, Low QJ, Rajahram GS

Hong Kong Med J, 2021 08;27(4):287-289.

PMID: 34413256 DOI: 10.12809/hkmj208815

Hepatic Sarcoidosis: Diagnostic approach and management

Hon SA, Lee LT, Tan KK, Lee RA, Low QJ

Med J Malaysia, 2021 Nov;76(6):914-917.

PMID: 34806684

Sarcoidosis is a multi-systemic, non-caseating granulomatous disorder with an idiopathic aetiology. We report a 58-year-old Malay woman, with underlying type II diabetes mellitus, hypertension and history of stage II pulmonary sarcoidosis presenting with incidental finding of multiple hypodense liver lesions. Her recent contrasted enhanced computed tomography of the abdomen and pelvis demonstrated multiple intra-abdominal lymphadenopathies with evidence of liver and splenic infiltrations. Her ageappropriate malignancy screening was negative while liver biopsy showed non-caseating granulomatous hepatitis consistent with hepatic sarcoidosis. In view of her normal liver enzymes and normalised serum calcium levels, no immunosuppressive therapy was commenced. She remains asymptomatic and is currently under our close monitoring.

Displaying publications 1 - 20 of 36 in total