Displaying publications 1 - 20 of 334 in total

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  1. Yousuf UA, Yashodhara BM, Thanigasalam T, Ting HS
    BMJ Case Rep, 2014 May 02;2014.
    PMID: 24792021 DOI: 10.1136/bcr-2013-203488
    A 58-year-old man presented with diplopia and partial ptosis for 10 years. It was non-progressive in nature, despite inadequate medical attention the patient received from non-specialists/general practitioners. He did not have fatigability or diurnal variation in weakness and was clinically stable without exacerbations of disease for a decade. He did not have features of Graves's disease, oculopharyngeal dystrophy, cranial nerve paralysis, polymyositis and stroke. The possibility of an atypical presentation of myasthenia gravis (MG) was considered and the patient was evaluated. Ice pack test was negative, Cogan's lid twitch (CLT) test was positive and high titres of acetylcholine receptor antibodies (AChR Ab) suggestive of MG were found. He was treated accordingly with a very good response.
  2. Ngiu CS, Ibrahim NM, Yahya WN, Tan HJ, Mustafa N, Basri H, et al.
    BMJ Case Rep, 2009;2009.
    PMID: 21709844 DOI: 10.1136/bcr.01.2009.1501
    Hashimoto encephalopathy (HE) is a poorly recognised steroid-responsive encephalopathy, with prominent neuropsychiatric features. Diagnosis is often difficult due to its heterogeneous clinical presentation, especially since the thyroid status or anti-thyroid antibody titres may not be related to the disease state. Here, the case of a 23-year-old Malay woman with Graves disease who presented with progressive encephalopathy diagnosed as HE is presented. She responded dramatically to high dose intravenous and then oral corticosteroid. A month after the initiation of treatment, she regained full independency.
  3. Saliem AM, Nimir AR, Abdul Kadir FA
    BMJ Case Rep, 2012;2012.
    PMID: 23087269 DOI: 10.1136/bcr-2012-006668
    Absence of the distal crease of the fingers is usually associated with a flexion deformity. A single crease of one or more fingers is found in many syndromes. We present this report as a rare case of absence of interphalangeal crease of the right ring finger with restriction of flexion but without any other anomaly.
  4. Bastion ML, Zahidin AZ
    BMJ Case Rep, 2010;2010.
    PMID: 22750927 DOI: 10.1136/bcr.11.2009.2497
    An unusual case of disciform keratitis developing in a patient with silicone oil-filled eye following vitrectomies for posterior globe rupture.
  5. Lim CC, Misron K, Liew YT, Wong EHC
    BMJ Case Rep, 2019 Nov 04;12(11).
    PMID: 31690691 DOI: 10.1136/bcr-2019-232275
    Acoustic neuroma (AN) usually manifests with asymmetric hearing loss, tinnitus, dizziness and sense of disequilibrium. About 10% of patients complain of atypical symptoms, which include facial numbness or pain and sudden onset of hearing loss. Patients with atypical symptoms also tend to have larger tumours due to the delay in investigation. We report a particularly interesting case of a patient presented to us with numbness over her right hemifacial region after a dental procedure without significant acoustic and vestibular symptoms. Physical examination and pure tone audiometry revealed no significant findings but further imaging revealed a cerebellopontine angle mass. The changing trends with easier access to further imaging indicate that the presentation of patients with AN are also changing. Atypical symptoms which are persistent should raise clinical suspicion of this pathology among clinicians.
  6. Yeap TB, Shabani NS, Bong CP, Tan HS
    BMJ Case Rep, 2021 Jul 13;14(7).
    PMID: 34257132 DOI: 10.1136/bcr-2021-244358
    Intraoperative impending compartment syndrome (ICS) is an extremely rare but lethal occurrence that can involve the upper and/or lower limb(s). It commonly occurs in patients who undergo anaesthesia in various special positions such as lithotomy, lateral decubitus or prone. We present a patient who developed an ICS of his left forearm during a cervical spine surgery in prone position. This devastating condition was fortunately identified when the pulse oximetry, intra-arterial wave form and motor-evoked potentials signal disappeared abruptly from our monitors. We discuss our perioperative challenges and management for the patient which had eventually saved the patient's limb.
  7. Saniasiaya J, Kulasegarah J
    BMJ Case Rep, 2023 Dec 28;16(12).
    PMID: 38154869 DOI: 10.1136/bcr-2023-258290
    Audiovestibular symptoms following COVID-19 have been long acknowledged, especially in adults. However, acute labyrinthitis presenting as an early manifestation of COVID-19 has not been reported in children. We report COVID-19-induced acute labyrinthitis in a teenager. We report on a boy in his early adolescence with a sudden onset of spinning sensation, imbalance and unilateral hearing loss with a positive SARS-CoV-2 test. Vestibular investigations point towards right labyrinthine hypofunction, and an audiometry test revealed right-sided severe hearing loss. Symptoms improved gradually with steroids and vestibular rehabilitation therapy. However, the long-term repercussions of post-COVID-19 acute labyrinthitis are unknown and must be followed up closely. To our knowledge, this is the first reported case of acute labyrinthitis secondary to COVID-19 in paediatrics. Additionally, we conducted a literature search to elucidate the outcome of COVID-19-induced acute vestibular syndrome in children.
  8. Nawawi SH, Wan Ibrahim WZ, Yahya MM, Ramli R
    BMJ Case Rep, 2023 Aug 17;16(8).
    PMID: 37591622 DOI: 10.1136/bcr-2022-253129
    A woman in her early 50s with uncontrolled diabetes mellitus and a huge uterine fibroid presented to the emergency department with diabetic ketoacidosis and bilateral acute lower limb ischaemia. Vascular and advanced imaging studies confirmed distal aortic compression by a huge uterine fibroid, resulting in extensive lower limb arterial thrombosis. After resuscitation, the patient underwent emergency hysterectomy, thromboembolectomy and amputation of the right leg. She remained critically ill and died of fulminant sepsis and multiorgan failure 10 days later. This case reports the effects of external vascular compression by a large pelvic mass.
  9. Mahmod M, Nor IF, Maskon O
    BMJ Case Rep, 2010;2010.
    PMID: 22448190 DOI: 10.1136/bcr.02.2009.1549
    While selective non-steroidal anti-inflammatory drugs, namely cyclo-oxygenase-2 (COX 2) inhibitors, are known to be associated with acute myocardial infarction, little is known about the cardiovascular safety of the non-selective non-steroidal anti-inflammatory drugs. We report the case of a 44-year-old man who developed anaphylactic reaction and acute inferior myocardial infarction following ingestion of a non-selective anti-inflammatory drug, diclofenac sodium. Coronary angiography revealed a large thrombus in the right coronary artery which was partially removed by intracoronary catheter aspiration. Complete resolution of the remaining thrombus was achieved after treatment with an oral anticoagulant.
  10. Foo CH, Hii BYS, Wong CC, Ohn KM
    BMJ Case Rep, 2021 Jul 12;14(7).
    PMID: 34253529 DOI: 10.1136/bcr-2021-243788
    Postoperative pseudomeningocele usually has a benign course. We report a rare presentation of postoperative acute neurological deficit caused by compressive thoracic pseudomeningocele. This patient had posterior spinal fusion and decompression surgery for thoracic ossification of posterior longitudinal ligament and ligamentum flavum. Intraoperative incidental durotomy was covered with hydrogel dural sealant. She developed acute neurological deterioration 1 week after index surgery. Emergency decompression surgery was performed. One year after the surgery, she showed good neurological recovery.
  11. Thiagarajah R, Sellamuthu P, Bharmjit Singh SS, Muniandy RK
    BMJ Case Rep, 2021 Aug 09;14(8).
    PMID: 34373248 DOI: 10.1136/bcr-2021-242276
    Sarcomas are a group of rare malignant tumours of the connective tissues. They can occur in almost any location, but more frequently in the extremities. The occurrence of sarcomas in the head and neck region is less than 1%. We are presenting a case report of a very large cranial sarcoma. Gross total tumour excision was done with pedicle skin graft and titanium mesh cranioplasty. The excised tumour weighed approximately 1.1 kg. Histopathological examination showed primitive intermediate-sized tumour cells arranged in sheets, nests and cords with focal palisading. Postoperative MRI done 2 weeks post surgery showed no evidence of residual tumour.
  12. Periyasamy P, Subramaniam SR, Rajalingham S
    BMJ Case Rep, 2011;2011.
    PMID: 22675021 DOI: 10.1136/bcr.09.2011.4816
    Data from the WHO state that up to 85% of cases of human schistosomiasis are from Africa. The common sites of this parasitic infection are the intestine and bladder. Testicular schistosomiasis is extremely rare but the number of reported cases worldwide has doubled over the past decade. The authors report a case of testicular schistosomiasis of a Myanmar immigrant in Malaysia who presented with a 6-month history of progressively enlarging left testicular swelling. His biochemical markers and cultures were not suggestive of an ongoing infection. Hence, a testicular malignancy was strongly suspected, for which, he underwent a left orchidectomy. Our clinical suspicion was proven wrong when the histopathology of the removed left testis revealed schistosomal eggs with granulamatous tissue formation. Subsequently, the patient was treated with praziquantel.
  13. Yeap TB, Teah MK, Ramly AKM, Bong CP
    BMJ Case Rep, 2021 Apr 09;14(4).
    PMID: 33837036 DOI: 10.1136/bcr-2021-242118
    Anaesthesia for patients with huge mediastinal mass is very challenging due to the cardiorespiratory embarrassment that may occur. We present a patient with this condition, which was complicated by total airway obstruction, intraoperatively. We discuss the importance of patient positioning and the role of spontaneous ventilation.
  14. Yeap TB, Teah MK, Thevarajah S, Azerai S
    BMJ Case Rep, 2021 Mar 25;14(3).
    PMID: 33766970 DOI: 10.1136/bcr-2020-241176
    Wolff-Parkinson-White (WPW) syndrome is an extremely rare congenital cardiac conduction disorder. It is due to an aberrant pathway between the atrium and ventricle. This manuscript entails a man with an underlying WPW who was posted for an elective orchidectomy. We discussed the important perioperative precautions to prevent the precipitation of acute cardiac events.
  15. Jamil J, Wan Hassan WMN, Ghani AR, Yeap TB
    BMJ Case Rep, 2023 Feb 16;16(2).
    PMID: 36796871 DOI: 10.1136/bcr-2022-250640
    Acromegaly is a progressive systemic disorder which is common among middle-aged women. A functioning growth hormone-secreting pituitary adenoma is the most common cause. Anaesthesia for pituitary surgery in patients with acromegaly is challenging. Rarely, these patients may develop thyroid lesions that may compromise the airway. We present the case of a young man with newly diagnosed acromegaly caused by a pituitary macroadenoma complicated by a large multinodular goitre. The aim of this report is to discuss the perianaesthetic approach in patients with acromegaly with a high risk of airway compromise undergoing pituitary surgery.
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