Displaying publications 1 - 20 of 28 in total

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  1. Mycotic iliac artery aneurysm with appendicitis in a pediatric patient
    Sunil SP, Aimanan K, Ismazizi Z
    Med J Malaysia, 2021 03;76(2):270-272.
    PMID: 33742645
    Iliac aneurysms are rare in children, especially mycotic aneurysms. Re-vascularization is challenging given the infected field and concern on patency due to their growth potential and a longer life-span. We report a complex case of a mycotic iliac aneurysm in a child. A 12-years-old boy with a previous history of infective endocarditis was referred to us for a right common iliac mycotic aneurysm after presenting with pain. A balloon-expandable stent-graft was deployed across the aneurysm during the acute presentation. He improved post-operatively, but developed abdominal pain four weeks later. A repeat computed tomography (CT) imaging showed a new inflammation of the appendix which was adhered to the calcified wall of the aneurysm and an endoleak from the internal iliac artery. A laparotomy was performed and the right internal iliac artery ligated along with an appendicectomy and omental pedicle. Postoperatively the patient was well and discharged home. Six-month surveillance revealed a healthy child and imaging showed a patent stent-graft and no residual collection.
    Matched MeSH terms: Appendix
  2. Fulltext Intraspecific macroscopic digestive anatomy of ring-tailed lemurs (Lemur catta), including a comparison of frozen and formalin-stored specimens
    Clauss M, Trümpler J, Ackermans NL, Kitchener AC, Hantke G, Stagegaard J, et al.
    Primates, 2021 Mar;62(2):431-441.
    PMID: 33180215 DOI: 10.1007/s10329-020-00873-8
    Digestive tract measurements are often considered species specific, but little information exists on the degree to which they change during ontogeny within a species. Additionally, access to anatomical material from nondomestic species is often limited, with fixed tissues possibly representing the only available source, though the degree to which this material is representative in terms of dimensions and weight is debatable. In the present study, the macroscopic anatomy of the digestive tract (length of intestinal sections, and tissue weights of stomach and intestines) of 58 Lemur catta [ranging in age from 1 month (neonates) to 25 years], which had been stored frozen (n = 27) or fixed in formalin (n = 31), was quantified. Particular attention was paid to the caecum and the possible presence of an appendix. The intraspecific allometric scaling of body mass (BM)0.46[0.40;0.51] for total intestine length and BM0.48[0.41;0.54] for small intestine length was higher than the expected geometric scaling of BM0.33, and similar to that reported in the literature for interspecific scaling. This difference in scaling is usually explained by the hypothesis that, to maintain optimal absorption, the diameter of the intestinal tube cannot increase geometrically. Therefore, geometric volume gain of increasing body mass is accommodated for by more-than-geometric length scaling. According to the literature, not all L. catta have an appendix. No appendix was found in the specimens in the present study. The proportions of length measurements did not change markedly during ontogeny, indicating that the proportions of the foetus are representative of those of the adult animal. By contrast, width and tissue-mass scaling of the caecum indicated disproportionate growth of this organ during ontogeny that was not reflected in its length. Compared to overall intraspecific variation, the method of storage (frozen vs. formalin) had no relevant impact on length or weight measurements.
    Matched MeSH terms: Appendix
  3. Diverticular disease of the large bowel in Singapore. An autopsy survey
    Lee YS
    Dis Colon Rectum, 1986 May;29(5):330-5.
    PMID: 3084185
    One thousand fourteen consecutive large intestines were removed at autopsy from persons over the age of 14 years and examined for diverticular disease. Diverticulosis was encountered in 194 patients (19 percent). The lesion appeared early in life, after the second decade. Men were affected more frequently than women before the age of 60 years. Chinese men had significantly more diverticular disease than Malayan men (P less than 0.01) and Indian men (P less than 0.02). Chinese men also had significantly more diverticular disease than Chinese women. There was a predominance of right colon involvement, with the disease affecting especially the ascending colon and cecum. This pattern was observed in all three major ethnic groups, and in both the Singapore-born and foreign-born Singaporeans. The cause of right-sided diverticulosis is unknown. It appears that, while adoption of the western diet may influence the prevalence of diverticular disease, the site of predilection is determined more by racial or genetic predisposition. All diverticula examined histologically were false, including 39 (20 percent) solitary diverticula. The distribution of solitary diverticula was similar to that of multiple diverticulosis. It is suggested that solitary and multiple diverticulosis are part of the spectrum of the same disease.
    Matched MeSH terms: Appendix/pathology
  4. Fulltext Issues in management of acute appendicitis in pregnancy
    Nalliah, Sivalingam, Wijesuriya, Lionel, Venugopal, Subramani
    International e-Journal of Science, Medicine & Education, 2011;5(1):2-9.
    MyJurnal
    Acute appendicitis is an infrequent yet the commonest surgical emergency in pregnancy occurring in about 1:1500 pregnancies. The classical abdominal pain in the right lower quadrant of the abdomen is the only reliable clinical sign. Delay in diagnosis is attributed to presence of symptoms commonly seen in pregnancy like nausea and vomiting and difficulty in localizing abdominal pain due to displacement of the appendix with advancing gestation. Perforated appendix and generalized peritonitis impacts adversely on pregnancy contributing to increases in miscarriage, pre-term delivery, fetal loss and even maternal mortality. Imaging studies like abdominal ultrasonogram, helical computerized tomography and magnetic imaging have been utilized to complement clinical suspicion and decrease ‘negative appendectomies’ but robust data on their routine use is awaited. Although the laparoscopic approach is a useful diagnostic and therapeutic tool in early pregnancy, its use as the primary approach for appendicectomy in pregnancy requires further evaluation as increases in the incidence of fetal loss of 5.6% has been reported compared to 3.1% in open access surgery
    Matched MeSH terms: Appendix
  5. Fulltext A Case of Appendiceal Goblet Cell Carcinoid Tumor: Getting it right under the Microscope
    Kang WH, Wahab NA, Kamaruddin NA
    J ASEAN Fed Endocr Soc, 2020;35(1):102-104.
    PMID: 33442175 DOI: 10.15605/jafes.035.01.16
    Goblet cell carcinoid (GCC) is a rare neoplasm of the vermiform appendix and can be mistaken as a typical neuroendocrine tumour (TNET). The natural history of this disease is more aggressive compared to TNETs and requires a more aggressive approach. We report a case of a 37-year-old male who was initially diagnosed with TNET, but subsequently revised as Tang's A GCC. He underwent appendectomy and right hemicolectomy. Aside from a persistently elevated carcinoembyrogenic antigen (CEA) result, his 18F-fluorodeoxyglucose (FDG) PET/CT and a 68-Gallium DOTATATE PET/CT scan showed no FDG or DOTATATE avid lesions.
    Matched MeSH terms: Appendix
  6. Microscopic studies on postmortem vermiform appendix of the adult males of Bangladesh
    Bakar SM, Shamim M, Salam A, Sultana SA
    Ir J Med Sci, 2016 Feb;185(1):249-57.
    PMID: 25894278 DOI: 10.1007/s11845-015-1287-4
    BACKGROUND: The anatomy of the vermiform appendix shows variations in its macroscopic dimensions and microscopic features, some of which have potentials of influencing the clinical aspects of the appendix.

    AIM: The aim of this study was to find out some microscopic features of appendix and evaluate the correlation between the microscopic features of the appendix and the age of the subjects and to determine whether these findings should influence the clinical implications of appendix.

    METHODS: In this cross-sectional observational study, thirty adult males' (age from 18 to 67 years) postmortem appendices and adnexa from Bangladeshi victims of road traffic accidents were sectioned at the base, midzone and tip stained with H+E stain and examined under microscope. Measurements were taken at the base, at the midzone and at the tip of the appendix, and the mean of the three measurements was considered as the overall value.

    RESULTS: The overall number of mucosal glands in a section ranged from 42.33 to 130.00 and the number of the germinal centres varied between 2.33 and 10.00. The overall luminal diameter ranged between 1764.58 and 3208.33 µm. The overall luminal diameter in more than 52 % of cases was between 2700.00 and 3299.99 µm with a median value of 2750 µm.

    CONCLUSION: The overall number of mucosal glands showed a tendency towards a positive correlation with age. The overall luminal diameter and the overall number of germinal centres showed a tendency towards a negative correlation with the age. However, none of the tendencies of correlation reached statistically any significant level.

    Matched MeSH terms: Appendix/pathology*
  7. Fulltext A study of parasitic infections in the luminal contents and tissue sections of appendix specimens
    Thanikachalam MP, Kasemsuk Y, Mak JW, Sharifah Emilia TS, Kandasamy P
    Trop Biomed, 2008 Aug;25(2):166-72.
    PMID: 18948889 MyJurnal
    Appendicitis has a worldwide prevalence and affects all age groups. The aetiology of acute appendicitis is still much debated, many factors have been implicated. The pathology is likely to be due to obstruction of the lumen of the appendix. Parasites, both helminths and protozoa have been suggested to be the cause of acute appendicitis. Studies have demonstrated that parasites are present in the appendix specimens removed from surgery methods.
    Matched MeSH terms: Appendix/parasitology*
  8. Rare complication of appendix: small bowel gangrene caused by the appendicular knot
    Mohana RT, Zainal AA
    Med J Malaysia, 2017 12;72(6):370-371.
    PMID: 29308777 MyJurnal
    Intestinal knot formation was first described by Riverius in 16th century and later by Rokitansky in 1836. We report a very rare cause of small bowel gangrene caused by appendiceal knotting on to the ileum in a previously healthy mid aged lady. Patient underwent laparatomy and right hemicolectomy and primary anastomosis. The intra operative findings were the appendix was twisting (knotting) the small bowel about 40cm from the terminal ileum and causing gangrene to the segment of small bowel. Appendicitis is a common condition and management is usually straightforward. However we must be aware of rare complications which may arise that require a change from the standard treatment of acute appendicitis.
    Matched MeSH terms: Appendix/physiopathology*
  9. Incidence of Retrocaecal Acute Appendicitis at the Hospital Sultanah Nora Ismail (HSNI) Batu Pahat
    Nur Bazlaah B, Khairuzi S, Nabiha F, Mohd Nadzri M, Nur Bazilah B, Hirdayu AB, et al.
    Med J Malaysia, 2021 03;76(2):223-228.
    PMID: 33742632
    BACKGROUND: A surgical audit study among Batu Pahat population was conducted in determining the commonest position of appendix in post appendectomy.

    METHODOLOGY: This is a retrospective study. A total of 204 cases of patients underwent an appendectomy admitted to the surgical ward from January 2017 until January 2018 at Hospital Sultanah Nora Ismail (HSNI) were audited retrospectively.

    RESULTS: This findings showed different figures of ascendancy in gender among patients who underwent an appendectomy with females 58.8% and males 41.2%. The perforation rate was 40.7% and delay in diagnosis was found to be 19.1%. The perforated appendix had a significantly higher incidence in males with a correlation of p-value 0.04. Retrocaecal appendix (RA) remained the commonest position for patients who underwent an appendectomy with 26.9%. RA is associated with an increased incidence of perforation (p-value 0.01).

    CONCLUSION: The position of appendix in our patients who underwent an appendectomy is parallel to the reports available globally in that it is retrocaecal followed by retroileal as the commonest position among residence of Batu Pahat.

    Matched MeSH terms: Appendix
  10. Fulltext Acute appendicitis in pregnancy: a diagnostic and management challenge
    Zainur Rashid, Z., Sulaiha, S.A., Azmi, M.N.
    International Medical Journal Malaysia, 2014;13(1):77-80.
    MyJurnal
    Acute appendicitis is the most common extra-uterine surgical emergency encountered during pregnancy, but an accurate diagnosis is still an enigma. Anatomical shifting of the appendix by the enlarging uterus makes the clinical and sonographic diagnosis difficult. Prompt diagnosis and treatment are essential to prevent perforation, which increases the risk of fetal and maternal death. Surgical intervention, either by an open laparotomy or laparoscopy is the most appropriate treatment for appendicitis. This article reviews the epidemiology, clinical diagnosis, investigation, complications and treatment of acute appendicitis in pregnancy.
    Matched MeSH terms: Appendix
  11. Rupture of the caecum due to invasive amoebiasis
    Rohela M, Lee A, Khairul Anuar A, Zuminee MN, Johari S
    JUMMEC, 2000;5:51-52.
    This paper describes a case of invasive arnoebiasis in a 72 year old woman. About 1 week prior to admission she had right iliac fossa pain and physical examination suggested perforated appendix or carcinoma of caecum. Laparotomy revealed perforation of caecum. Histopathology of tissue removed showed abundant trophozoites of Entamoeba histolytica. After surgery treatment was instituted and patient had an uneventful recovery. KEYWORDS: Rupture of caecum, amoebiasis
    Matched MeSH terms: Appendix
  12. Fulltext A Cross-Sectional Study of Neutrophil-to-Lymphocyte Ratio in Diagnosing Acute Appendicitis in Hospital Melaka
    Ahmad KA, Ideris N, Aziz SHSA
    Malays J Med Sci, 2019 Nov;26(6):55-66.
    PMID: 31908587 DOI: 10.21315/mjms2019.26.6.6
    Background: Acute appendicitis is one of the most common surgical emergencies. However, its proper diagnosis is complicated. This study aims to evaluate the ability of the neutrophil-to-lymphocyte ratio (NLR) to diagnose acute appendicitis in pre-operative state.

    Methods: Histopathological examination of appendicectomies conducted between 2016 and 2017 in Melaka Hospital, Malaysia were traced and categorised into three groups: i) G1 (normal appendix), ii) G2 (acute appendicitis) and iii) G3 (perforated appendicitis). The reports were randomised and a total of 338 samples were collected. NLR values were compared between the three different groups and analysed.

    Results: The median values of NLR for G1, G2 and G3 were 2.37, 5.25 and 9.27, respectively. We found a statistically significant difference in NLR between G1 and G2 (P < 0.001), and G2 and G3 (P < 0.001). The diagnostic values of NLR for acute appendicitis and perforated appendicitis were 3.11 (sensitivity: 75.23%, specificity: 68.70%) and 6.17 (sensitivity: 76.32%, specificity: 58.72%), respectively. There was a substantial correlation between NLR and disease severity, and a moderate correlation between NLR and duration of admission.

    Conclusion: NLR, with a sensitivity of 75.23% and specificity of 68.70%, is a useful and reliable adjunct in diagnosing acute appendicitis. Hence, it will help in reducing the rate of negative appendicectomies.

    Matched MeSH terms: Appendix
  13. Fulltext Acute appendicitis: pathology of 1,000 cases
    Thanaletchimy N
    Med J Malaysia, 1986 Dec;41(4):336-42.
    PMID: 3670157
    A retrospective study of the pathology seen in 1,000 consecutive appendicectomy specimens with a pre-operative diagnosis of acute appendicitis, was made in an attempt to find common factors which might throw light on the aetiology of the disease. Acute inflammation was seen in 775 cases. In 225 cases where no inflammation was seen, 168 appendices were associated with other pathology, i.e., lymphoid hyperplasia, fibrosis and tumour. In 57 cases the appendix was not inflamed. Acute inflammation was seen more in males and in patients aged below 30 years, while normal appendices were more commonly seen in females of reproductive age.
    Matched MeSH terms: Appendix/parasitology; Appendix/pathology*
  14. Isolation of Aggregatibacter aphrophilus from a patient with acute appendicitis
    Aye AM, Law CW, Sabet NS, Karunakaran R, Hanifah YA, Jafar FL, et al.
    Eur Rev Med Pharmacol Sci, 2011 Jul;15(7):845-7.
    PMID: 21780555
    Acute appendicitis is a common surgical emergency. The etiology and pathophysiology of appendicitis have been well investigated. Aggregatibacter aphrophilus is a fastidious gram-negative coccobacilli. Detection of this organism in clinical samples and its differentiation from Haemophilus aphrophilus or from Aggregatibacter actinomycetemcomitans in routine microbiology settings could be difficult.
    Matched MeSH terms: Appendix/microbiology*; Appendix/surgery
  15. Fulltext Imaging as an aid to the diagnosis of acute appendicitis
    Wijesuriya LI
    Malays Fam Physician, 2007;2(3):106-9.
    PMID: 25606095 MyJurnal
    Acute appendicitis has been known as a disease entity for well over a century but a confident diagnosis before surgery in all patients suspected of the condition is still not possible. Timely diagnosis is essential to minimise morbidity due to possible perforation of the inflamed organ in the event treatment is delayed; so much so that surgeons often preferred to operate at the slightest suspicion of the diagnosis in the past. This resulted in the removal of many normal appendixes. When the diagnosis of appendicitis is clear from the history and clinical examination, then no further investigation is necessary and prompt surgical treatment is appropriate. Where there is doubt about the diagnosis however it is advisable to resort to imaging studies such as abdominal ultrasound or computed tomography to clear such suspicions before subjecting the patient to an appendicectomy. These studies would also help avoid delays in surgery in deserving patients.
    Matched MeSH terms: Appendix
  16. Fulltext Simultaneous omental infarction and acute appendicitis in a child
    Koay HT, Mahmoud HE
    Med J Malaysia, 2015 Feb;70(1):42-4.
    PMID: 26032530
    It is crucial to realize that both omental infarction and acute appendicitis can occur simultaneously in the children as both diseases are managed differently. Omental infarction itself is rare in the pediatric group, and its association with acute appendicitis is even rarer. Both diseases usually present with right sided abdominal pain. Ultrasound is the choice of imaging modality in the investigation of abdominal pain in the children. It should not be content if omental infarction is detected, whilst the normal appendix is not seen. We reported a case of simultaneous omental infarction and acute appendicitis in a child who presented with 3 days history of right sided abdominal pain. It was diagnosed preoperatively by ultrasound. Prompt surgical intervention was proceeded and the child made uneventful recovery.
    Matched MeSH terms: Appendix
  17. Malrotated Subhepatic Caecum with Subhepatic Appendicitis: Diagnosis and Management
    Chong HC, Chai FY, Balakrishnan D, Asilah SM, Adila IN, Syibrah KZ
    Case Rep Surg, 2016;2016:6067374.
    PMID: 27648337
    Subhepatically located caecum and appendix is a very rare entity. It occurs due to the anomaly in fetal gut rotation that results in an incomplete rotation and fixation of the intestine. Appendicitis, which is a common surgical emergency, in combination with the abnormal subhepatic location, presents a great challenge in its diagnosis and management. Here, we describe a 42-year-old male with chronic dyspepsia who presented with sepsis and severe pain at his right hypochondriac and epigastric region. The final diagnosis was acute appendicitis of the subhepatic appendix. Our discussion focuses on the diagnostic approach and clinical and surgical management. We hope that our report will increase the awareness among the clinicians and hasten the management of such rare condition to avoid complications.
    Matched MeSH terms: Appendix
  18. An unexpected gangrenous duplication of ileum
    Chiar CI, Elango T, Sivaneswaran L, Umasangar R, Mohan N
    Med J Malaysia, 2017 02;72(1):83-84.
    PMID: 28255153 MyJurnal
    Alimentary tract duplication is a rare congenital anomaly which may involve any part of the alimentary tract extending from stomach to rectum. Clinical presentation may mimic an inflamed appendix as described in this case. A 9-year-old boy with a clinical diagnosis of perforated appendix was noted to have a normal appendix intra-operatively. On further search for an underlying pathology, a gangrenous ileal duplication was discovered. En-bloc resection with primary bowel anastomosis was done. Histopathology report revealed a gangrenous small bowel duplication. We discuss the preoperative diagnostic dilemma and management options in approaching this rare entity.
    Matched MeSH terms: Appendix
  19. Fulltext Mucopyocele in the oral region: an unusual case
    Telang , Ajay, Lahari, T., Chacko , James P.
    Archives of Orofacial Sciences, 2011;6(2):1-4.
    MyJurnal
    Mucopyoceles are rare lesions defined as infected mucoceles. They have been reported only in the paranasal sinuses and appendix. Our case is the first to be reported in the oral region. A 58- year-old male presented with complaint of a painless swelling of two years duration in the right buccal sulcus with associated pus discharge. Radiographic examination ruled out pulpal and periodontal foci of infection and histopathology confirmed an underlying mucopyocele in the right buccal mucosa.
    Matched MeSH terms: Appendix
  20. Fulltext Implementing occupational safety and health requirements in construction project
    Firdaus Abd Latib, Haziq Zul Asyraf Zahari, Abdul Rahim Abdul Hamid, Kevin Chester Wong How Yee
    Journal of Advanced Research in Applied Sciences and Engineering Technology, 2016;5(1):53-63.
    MyJurnal
    The probability of the construction accident to happen is high due the nature of
    Construction work that involves complex activities, methods, machineries, materials
    and hazards. The occupational safety and health (OSH) law and regulations are
    mandatory for every construction project to uphold. Responsibilities to ensure the
    safety and health at the workplace lies with those who create the risk and with those
    who work with the risk. The owner or client of the construction project has the upper
    hand in determining the standard of OSH implementation in their project through
    contract documents. If the contract documents comprehensively spell out OSH
    requirements and cover all OSH cost, then the issues of contractor not implementing
    OSH measures could be minimized. The objective of this study is to identify
    Occupational Safety and Health requirements (OSH) in the contract document of
    selected construction projects. To achieve this objective, a total of seven contract
    document was collected from several construction companies. The qualitative analysis
    was performed to identify the extent of OSH requirements and costs are being
    mentioned in the contract documents. The finding shows that most of the contract
    document contains very little emphasis on OSH requirements and budgeting. Only one
    contract contains, an appendix that spell out about the safe work practices for
    construction works. The visible allocated budget for OSH requirements for all seven
    contracts is very minute range from 0.21% to 1.99% of contract value. In order to
    ensure that occupational safety and health is properly implemented, safety needs must
    be included in the budget because implementation it is not free, this can be achieved
    by making it a permanent feature in all bills of quantity of the project.
    Matched MeSH terms: Appendix
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