"Cauliflower Ears" describes the appearance of swelling of the auricular cartilage resulting in gross distortion of the auricle. The underlying pathology is inflammation of the auricular cartilage. We report a case of a patient who presented to the ophthalmology clinic with an ocular inflammation, whose subsequent diagnosis of replapsing polychondritis was clinched with the finding of "Cauliflower Ears". This case emphasizes the importance of an appropriate general examination of ophthalmic patients for early diagnosis and prompt institution of medical treatment, which may prevent life-threatening complications to the patient.
Study site: Eye clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Delay in commencing treatment in patients diagnosed with smear-positive pulmonary tuberculosis (PTB) may promote the spread of PTB in the community. Socio-demographic and clinical data from 169 patients (119 retrospectively and 50 prospectively collected) treated for smear-positive PTB in our hospital Chest Clinic from June 2002 to February 2003 were analysed. One hundred and fifty eight (93.5%) patients were started on treatment in less than 7 days from the time when the report first became available while 11 (6.5%) patients had their treatment started > or = 7 days. The median 'discovery to treatment' window was 1 day (range, 0 to 24 days). Of the factors studied, longevity of symptoms, absence of fever or night sweats and having sought traditional medicine were associated with delay in treatment commencement. The urgency and importance of anti-TB treatment should be emphasized especially to patients who are inclined towards treatment with traditional medicine.
Keywords: Smear positive, pulmonary tuberculosis, treatment delay, traditional medicine, Malaysia, Seremban, Negeri Sembilan
A 52-year-old man presented with a 2-year history of episodic retraction of his tongue into the throat with a belief that he will die if the retraction is complete. The presentation is similar to koro except that the tongue is involved instead of the penis. It appears that retraction taxon can involve other organs and may not necessarily be culture bound.
A rare case of pilocarpine-induced retinal detachment occurring in the only useful myopic eye of a young Chinese woman is described. Problems of treating raised intraocular pressure in high-risk cases of retinal detachment are discussed.
Over the past two decades there has been numerous new associations between chronic diseases traditionally considered non-infectious with infectious agents. This list of diseases include peptic ulcer, coronary heart disease, neuropsychiatric disorders, haematological disorders and malignancies. These associations have been made possible through improvements in diagnostic tests based on molecular biology techniques. The discovery of these associations is important as it opens up exciting opportunities for the prevention and treatment of many diseases hitherto considered incurable.
Postpartum is a crucial period for a mother. During this period a mother is going through the physiological process of uterine involution and at the same time adapting to her new role in the family. Many postpartum complications occur during this period. Among the important obstetric morbidities are postpartum hemorrhage, pregnancy related hypertension, pulmonary embolism and puerperal sepsis. Common surgical complications are wound breakdown, breast abscess and urinary fecal incontinence. Medical conditions such as anemia, headache, backache, constipation and sexual problems may also be present. Unrecognized postpartum disorders can lead to physical discomfort, psychological distress and a poor quality of life for the mothers. Providing quality postnatal care including earlier identification of the problems (correction) and proper intervention will help the mother to achieve full recovery and restore her functional status back to the pre-pregnancy state sooner.
The importance of an adequate caliber neo-meatus for success of any hypospadias repair cannot be overstated. TIP repair incorporates a midline relaxing incision thus enabling tubularization but ultimately may not result in adequate neourethral caliber to avoid fistulas or meatal stenosis when the plate was narrow or flat, respectively. Objectives of this study is to evaluate results of a modification of TIP - "wide skeletonization" tubularized incised plate (TIP) - for repair of distal penile hypospadias with narrow urethral plate (UP), with regard to meatal stenosis and urethrocutaneous fistula.
'Pai syndrome' (PS) is a rare congenital syndrome. Presented here, a new-born baby-girl who exhibited the characteristic features of having a midline nasal (septal) polyp, an anterior alveolar process polyp, and a pericallosal lipoma associated with corpus callosum dysgenesis of the brain. Both polyps were lined with stratified-squamous epithelium. The overall features were largely consistent with those described by Pai et al., in 1987. A midline cleft-lip (with or without cleft-alveolus) is one of the most common features of the syndrome which was however absent in this case. Instead, an anterior alveolar polyp is present, which is relatively rare.
Sixty-three breath samples were collected from patients who underwent a 14C-urea breath test. Following ingestion of a radiolabelled 14C-labelled urea solution, breath samples containing 14C-labelled carbon dioxide were trapped in a solution containing hyamine hydroxide. Samples were then counted in a liquid scintillation counter. Breath samples were collected at 2, 15, 20, 25 and 30 minutes following ingestion of the urea solution. The presence or absence of Helicobacter pylori (HP) infection was determined on the basis of endoscopic biopsy tests which included culture, histological examination, rapid urease test and a gram stain of a fresh tissue smear. Thirty-two HP positive and 31 HP negative samples were collected. The mean counts at 15, 20, 12 and 30 minutes time points were: 4413, 4458, 4109 and 3795 dpm respectively for the positive samples and 1275, 877, 690 and 565 dpm respectively for the negative samples. Based on a cutoff value (mean of the negative samples + 3 standard deviations) for every time point, HP positive and negative samples could be clearly differentiated giving a sensitivity and specificity of 100%. The 14C-urea breath test is a reliable and convenient diagnostic test for H. pylori.
A study was carried out on 16 cases of leptospirosis with acute renal failure (ARF) detected in adult patients admitted into the Medical and Nephrology wards of the General Hospital, Kuala Lumpur, over a four-year period from 1980 to 1983. Most of the cases were male, Malays and older adults. The predominant infecting serovars were L. celledoni (of the serogroup L. javanica and L. pomona (of the L. pomona serogroup]. All the cases survived, including those who required peritoneal dialysis. The sensitised erythrocyte lysis (SEL) antibody prevalence rate of the chronic renal failure cases (10.4%) was found to be similar to that of the healthy population in West Malaysia (12. 7%), confirming the observation by other workers that leptospirosis is not an important cause of chronic renal failure.