Displaying publications 1 - 20 of 810 in total

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  1. B, Elamathi, R, Vijaya, V, Valliappan, A, Ramanathan
    Ann Dent, 2014;21(1):33-37.
    MyJurnal
    According to the 3rd edition of the international
    classification of headache disorders (ICHD3 2013),
    Trigeminal Neuralgia (TN) is classified into two types:
    1. Classical TN, purely paroxysmal 2. Classical TN
    with concomitant persistent facial pain. In this article,
    the authors describe a 47 year-old, male with unilateral,
    severe, recurring, electric shock-like pain involving left
    lower jaw, teeth and gingiva. Diagnosis of classical TN
    of the left 3rd division of the trigeminal nerve was made.
    The patient was treated with pharmacotherapeutic agents
    but without relief. Magnetic resonance imaging (MRI)
    of the brain showed medial vascular compression of left
    trigeminal pontine root entry zone caused by superior
    cerebellar artery. A microvascular decompression (MVD)
    surgery was done at the left trigeminal pontine root entry
    zone resulting in good relief of pain. This article highlights
    the differential diagnoses to be considered with TN and
    also emphasize the difference between the two types of
    the TN according to ICDH3 (2013). It also highlights the
    difference between classical TN purely paroxysmal with
    and without vascular compression by imaging techniques
    and their differing treatment modalities, which therefore
    should be reflected in future ICDH classification.
    Matched MeSH terms: Diagnosis, Differential
  2. Sarin SK, Choudhury A, Sharma MK, Maiwall R, Al Mahtab M, Rahman S, et al.
    Hepatol Int, 2019 Jul;13(4):353-390.
    PMID: 31172417 DOI: 10.1007/s12072-019-09946-3
    The first consensus report of the working party of the Asian Pacific Association for the Study of the Liver (APASL) set up in 2004 on acute-on-chronic liver failure (ACLF) was published in 2009. With international groups volunteering to join, the "APASL ACLF Research Consortium (AARC)" was formed in 2012, which continued to collect prospective ACLF patient data. Based on the prospective data analysis of nearly 1400 patients, the AARC consensus was published in 2014. In the past nearly four-and-a-half years, the AARC database has been enriched to about 5200 cases by major hepatology centers across Asia. The data published during the interim period were carefully analyzed and areas of contention and new developments in the field of ACLF were prioritized in a systematic manner. The AARC database was also approached for answering some of the issues where published data were limited, such as liver failure grading, its impact on the 'Golden Therapeutic Window', extrahepatic organ dysfunction and failure, development of sepsis, distinctive features of acute decompensation from ACLF and pediatric ACLF and the issues were analyzed. These initiatives concluded in a two-day meeting in October 2018 at New Delhi with finalization of the new AARC consensus. Only those statements, which were based on evidence using the Grade System and were unanimously recommended, were accepted. Finalized statements were again circulated to all the experts and subsequently presented at the AARC investigators meeting at the AASLD in November 2018. The suggestions from the experts were used to revise and finalize the consensus. After detailed deliberations and data analysis, the original definition of ACLF was found to withstand the test of time and be able to identify a homogenous group of patients presenting with liver failure. New management options including the algorithms for the management of coagulation disorders, renal replacement therapy, sepsis, variceal bleed, antivirals and criteria for liver transplantation for ACLF patients were proposed. The final consensus statements along with the relevant background information and areas requiring future studies are presented here.
    Matched MeSH terms: Diagnosis, Differential
  3. Che Mohamed SK, Abd Aziz A
    Malays J Med Sci, 2009 Oct;16(4):69-72.
    PMID: 22135515 MyJurnal
    When performing a radiological assessment for a trauma case with associated head injury, a fragment of dense tissue detected near the craniovertebral junction would rapidly be assessed as a fractured bone fragment. However, if further imaging and evaluation of the cervical spine with computerised tomography (CT) did not demonstrate an obvious fracture, then the possibility of ligament calcification would be considered. We present a case involving a previously healthy 44-yearold man who was admitted following a severe head injury from a road traffic accident. CT scans of the head showed multiple intracranial haemorrhages, while scans of the cervical spine revealed a small, well-defined, ovoid calcification in the right alar ligament. This was initially thought to be a fracture fragment. Although such calcification is uncommon, accident and emergency physicians and radiologists may find this useful as a differential diagnosis in patients presenting with neck pain or traumatic head injury.
    Matched MeSH terms: Diagnosis, Differential
  4. Chan GF, Sinniah S, Idris TI, Puad MS, Abd Rahman AZ
    Pak J Biol Sci, 2013 Mar 01;16(5):208-18.
    PMID: 24175430
    Persistent superficial skin infection caused by multiple fungi is rarely reported. Recently, a number of fungi, both opportunistic and persistent in nature were isolated from the foot skin of a 24-year old male in Malaysia. The fungi were identified as Candida parapsilosis, Rhodotorula mucilaginosa, Phoma spp., Debaryomyces hansenii, Acremonium spp., Aureobasidium pullulans and Aspergillus spp., This is the first report on these opportunistic strains were co-isolated from a healthy individual who suffered from persistent foot skin infection which was diagnosed as athlete's foot for more than 12 years. Among the isolated fungi, C. parapsilosis has been an increasingly common cause of skin infections. R. mucilaginosa and D. hansenii were rarely reported in cases of skin infection. A. pullulans, an emerging fungal pathogen was also being isolated in this case. Interestingly, it was noted that C. parapsilosis, R. mucilaginosa, D. hansenii and A. pullulans are among the common halophiles and this suggests the association of halotolerant fungi in causing persistent superficial skin infection. This discovery will shed light on future research to explore on effective treatment for inhibition of pathogenic halophiles as well as to understand the interaction of multiple fungi in the progress of skin infection.
    Matched MeSH terms: Diagnosis, Differential
  5. Alhabshi SM, Abd Rashid M
    BMJ Case Rep, 2013;2013.
    PMID: 23429032 DOI: 10.1136/bcr-2013-008680
    Aggressive angiomyxoma is a benign soft tissue tumour usually affecting the pelvis and perineum predominantly in women. Because of its variable presentation, this tumour is often clinically misdiagnosed as liposarcoma. We describe a case of a 38-year-old woman who presented with a large perineal and gluteal mass which increased in size in one year. Ultrasound showed hypoechoic mixed solid and cystic mass. Contrasted CT and MRI examinations showed typical appearance of swirling and layering pattern. She had undergone TAHBSO as the mass was difficult to dissect intra-operatively. The post-operative specimen confirmed to be an aggressive angiomyxoma.
    Matched MeSH terms: Diagnosis, Differential
  6. Khoo JJ, Alwi RI, Abd-Rahman I
    Malays J Pathol, 2009 Jun;31(1):77-80.
    PMID: 19694319 MyJurnal
    Breast hamartoma is an uncommon poorly recognised benign breast neoplasm. Hamartoma displaying marked smooth muscle components known as myoid hamartoma of the breast is a much rarer entity. We present a case of myoid hamartoma of breast with chondroid differentiation in a 46-year-old woman. The painless breast lump was circumscribed and mammography showed a well-encapsulated large, dense mass with no calcification. Core needle biopsy was reported as fibroadenoma. The lesion was excised. Microscopically, it composed of many groups of mammary glandular components with dense fibrous stroma, adipose tissue and marked groups of smooth muscle fibres. Foci of chondroid differentiation were noted in the lesion. The smooth muscle cells showed strong and diffuse immunoreactivity for vimentin, myogloblin, alpha-smooth muscle actin, desmin and CD34 and failed to express pan-cytokeratin or S100 protein. The ducts lined by epithelial cells were reactive to pan-cytokeratin while the myoepithelial cells were reactive to S100 protein. The various immuno-histochemical staining as well as the cyto-histological changes encountered in myoid hamartomas are discussed with clinical, radiological and pathological correlation to differentiate it from other benign and malignant breast lesions.
    Matched MeSH terms: Diagnosis, Differential
  7. Abdul Ghani R, Mohamed Shah FZ, Hanafiah M, Abdul Aziz M
    BMJ Case Rep, 2019 Feb 01;12(2).
    PMID: 30709882 DOI: 10.1136/bcr-2018-225687
    A 30-year-old ex-smoker with a background history of childhood asthma presented with worsening shortness of breath despite receiving high doses of oral corticosteroid for pemphigus vulgaris which was diagnosed 5 years earlier. A high-resolution CT examination of the thorax reported non-specific bronchiectatic changes and revealed an incidental suprarenal mass. A subsequent CT scan confirmed a large adrenal mass with areas of necrosis and calcification. Serum renin and aldosterone, urinary catecholamine and 5-hydroxyindoleacetic acid were within normal limits. Surgical intervention was delayed due to difficulty in optimising preoperative respiratory functions. He finally underwent a midline laparotomy for removal of the tumour. Histopathological examinations revealed extrapulmonary inflammatory myofibroblastic tumour arising from the periadrenal soft-tissue, with presence of normal adrenal gland. He showed immediate improvements of his asthmatic symptoms and pemphigus vulgaris following the surgery. His oral steroid was rapidly reduced and he achieved complete remission 2 months later.
    Matched MeSH terms: Diagnosis, Differential
  8. Masiran R, Abdul Aziz MF
    BMJ Case Rep, 2017 Aug 28;2017.
    PMID: 28847993 DOI: 10.1136/bcr-2017-220631
    A patient with bipolar I disorder has been treated with lithium and haloperidol for the last 20 years and received an ACE inhibitor for his hypertension since 9 years ago. Despite regular clinic follow-ups and blood monitoring, he recently developed tremors and delirium. On hospital admission, serum level of lithium was far above toxic level. Mental state examination revealed an anxious and disorientated man with irrelevant speech. Immediate discontinuation of lithium resulted in slow reduction of serum lithium levels and gradual resolution of tremor but his delirium persisted for 2 weeks. His condition took a turn for the worse when he developed acute renal failure and arm abscess. We discussed about lithium toxicity and the vulnerability factors which have induced delirium and renal failure in this patient.
    Matched MeSH terms: Diagnosis, Differential
  9. Lai C, Mohammad N, Hassan TM, Abdul Hamid MF
    BMJ Case Rep, 2017 Sep 11;2017.
    PMID: 28893806 DOI: 10.1136/bcr-2017-221239
    This case series reviews two cases of elderly patients who presented with fever, cough and shortness of breath. Clinical examinations and initial chest radiographs confirmed unilateral pleural effusion. Thoracenteses were consistent with exudative pleural effusion. We commenced intravenous antibiotics treating for parapneumonic effusions. The first case showed persistent effusion despite drainage, and the second case had a little aspirate from pleural tapping. Subsequent ultrasound of the thorax showed multiloculated effusions. We made the decisions for intrapleural fibrinolytic therapy using low-dose alteplase 2.5 mg each time, in view of the elderly patient as sacrosanct for risk of bleeding. Furthermore, DNase was not used, as it is not yet available in our setting. Both of our patients had good clinical and radiological outcomes, without the need for surgical interventions.
    Matched MeSH terms: Diagnosis, Differential
  10. Ho YL, Ng PF, Krishinan S, Abdul Kareem BA
    J Cardiothorac Surg, 2021 May 29;16(1):151.
    PMID: 34051789 DOI: 10.1186/s13019-021-01526-7
    BACKGROUND: Papillary fibroelastomas are rare but benign cardiac tumour that are often found on cardiac valvular surfaces. Their clinical manifestations ranging from clinically asymptomatic to substantial complications that are usually secondary to systemic embolism. Multiple theories have been proposed to explain the pathophysiology of its formation.

    CASE PRESENTATION: We reported a rare case of large papillary fibroelastoma in the right atrium of a young gentleman which was complicated with pulmonary embolism. Transthoracic echocardiography identified a large pedunculated mass measuring 3.4cmX3.4cmX2cm in right atrium with stalk attached to interatrial septum. The intracardiac mass was resected surgically, which revealed papillary fibroelastoma in histology examination.

    CONCLUSION: Differential diagnosis of intracardiac masses requires clinical information, laboratory tests and imaging modalities including echocardiography. Incidentally discovered papillary fibroelastomas are treated on the basis of their sizes, site, mobility and potential embolic complications. Due to the embolic risk inherent to intraacardiac masses, surgical resection represents an effective curative protocol in treating both symptomatic and asymptomatic right sided and left sided papillary fibroelastomas, with excellent long term postoperative prognosis.

    Matched MeSH terms: Diagnosis, Differential
  11. Ng KH, Siar CH, Abdul Latif H
    Ann Dent, 1992;51(1):29-31.
    PMID: 1632624
    Leiomyomas are benign neoplasms of smooth muscle origin. They represent rare entities in the oral cavity. A case arising from the incisive papilla region of a 3-month-old infant is described and the histogenesis as well as the biologic potential of this tumor are discussed.
    Matched MeSH terms: Diagnosis, Differential
  12. Alias H, Doris Lau SC, Loh CK, Ishak MI, Mohammed F, Jamal R, et al.
    J Pediatr Hematol Oncol, 2017 11;39(8):e463-e465.
    PMID: 28859035 DOI: 10.1097/MPH.0000000000000960
    Giant cell tumor (GCT) is one of the most common tumors of bone and is the most common precursor of aneurysmal bone cysts (ABC). The clinical behavior of concurrent GCT and ABC can be very aggressive in children. GCT of the ribs, with or without ABC, is rarely seen in children. We report a case of an 8-year-old girl with GCT and associated ABC of the ribs who presented with sudden onset of chest pain and breathlessness due to a hemothorax. The patient was successfully treated by surgical resections and arterial embolization. She has remained well for 4 years after the initial surgery.
    Matched MeSH terms: Diagnosis, Differential
  13. Md Noh MSF, Abdul Rashid AM, Abdul Rahim E
    J Bronchology Interv Pulmonol, 2018 07;25(3):e30-e32.
    PMID: 29944591 DOI: 10.1097/LBR.0000000000000456
    Matched MeSH terms: Diagnosis, Differential
  14. Saniasiaya J, Mohamad I, Abdul Rahman SK
    Braz J Otorhinolaryngol, 2016 06 22;86(3):389-392.
    PMID: 27388958 DOI: 10.1016/j.bjorl.2016.05.011
    Matched MeSH terms: Diagnosis, Differential
  15. Siar, C.H., Ibrahim, N., Omar, A.N., Abdul Rahman, Z.A.
    Ann Dent, 2010;17(1):21-24.
    MyJurnal
    Differential diagnosis of orofacial pain is crucial, as the course of each process and its clinical management varies markedly. A case is illustrated here of trigeminal neuralgia in a 49-year-old Indian female whose complaint was initially diagnosed as dental pain leading to sequential extractions of her right mandibular and maxillary molars but with no pain abatement. Subsequent neurological assessment diagnosed her complaint as trigeminal neuralgia but pain remained poorly controlled even with high doses of carbamazepine and gabapentin. A dental referral and orthopantomographic examination revealed multifocal sclerotic masses in her jaws, suggestive of florid cemento-osseous dysplasia (FCOD). Right mandibular incisional biopsy confirmed the diagnosis. A decision was made to curette the right mandibular masses and lateralised the right inferior dental nerve. Follow-up disclosed considerable pain reduction. This case raises the issue as to whether the sclerotic bone masses in FCOD may have caused nerve compression which
    aggravated her neuralgic pain.
    Matched MeSH terms: Diagnosis, Differential
  16. Mohd Esa NY, Mohd Radzi AA, Bakar NS, Mohd Khalid MS, Ismail AI, Abdul Rani MF
    Respirol Case Rep, 2016 May;4(3):e00155.
    PMID: 27516884 DOI: 10.1002/rcr2.155
    Teratomas of anterior mediastinum are rare. They are often slow growing, asymptomatic, and detected incidentally on chest imaging. Mycobacterium abscessus (M. abscessus) is an acid-fast bacillus that is classified as a pathogenic "rapid growing" non-tuberculous mycobacteria. It is an uncommon cause of human pathology, which may cause skin and soft tissue infection after skin injury following inoculation, minor trauma, and surgery. Here, we present an unusual case of benign cystic teratoma mimicking recurrent pleural effusion, which was subsequently complicated by M. abscessus infection following thoracotomy. Cystic teratoma is rare, but it needs to be considered whenever clinical and investigative work-up fails to provide a convincing diagnosis. A combined clinical, radiological, surgical, and histopathological assessment is important to arrive at the correct diagnosis. Rapidly growing mycobacteria needs to be included in the differential diagnosis of patients with non-resolving infected post-thoracotomy wound and who do not respond to broad-spectrum antibiotics.
    Matched MeSH terms: Diagnosis, Differential
  17. Dinesh BJ, Hayati F, Azizan N, Abdul Rashid NF
    BMJ Case Rep, 2019 Sep 18;12(9).
    PMID: 31537599 DOI: 10.1136/bcr-2019-231516
    Florid papillomatosis (FP) of the nipple, or nipple adenoma, is a rare breast tumour, affecting middle-aged group population. A 46-year-old woman presented to us with a cauliflower-like FP of the right nipple with no blood stained discharge or breast lump. FP can be mistaken clinically for Paget's disease and occasionally misinterpreted as invasive ductal or intraductal carcinoma. Extensive intervention, correct diagnosis and prompt treatment are essential. Any breast pathology requires triple assessment including FP of the nipple. Once the diagnosis of ductal carcinoma is excluded, simple complete excision can be undertaken. This is to ensure complete obliteration of disease recurrence and preservation of cosmetic result. We discuss the pathology and psychosocial aspects of FP.
    Matched MeSH terms: Diagnosis, Differential
  18. Ahmad R, Abdul Latiff AK, Abdul Razak S
    PMID: 18613550
    We describe a 5-year-old girl who had sudden onset difficulty in walking after 3 days of febrile illness. In the emergency department her creatine kinase level was elevated but urine myoglobin was normal. She was diagnosed as having benign acute childhood myositis. Because of poor oral intake and dehydration, she was admitted to the pediatric ward. The next day she had a petechial rash over the antecubital fossa, and dengue IgM back was positive. She was treated conservatively and recovered uneventfully. Despite dengue fever being endemic in Malaysia, this is the first case report of myositis following dengue infection in Malaysia.
    Matched MeSH terms: Diagnosis, Differential
  19. Shaharir SS, Tumian NR, Yu Lin AB, Abdul Wahid SF
    J Infect Dev Ctries, 2013 Mar;7(3):286-8.
    PMID: 23493009 DOI: 10.3855/jidc.2691
    Tuberculosis is notoriously known to be a great mimicker of other diseases and may cause various haematologic abnormalities, especially with marrow involvement. A 61-year-old man who presented with right empyema and pancytopenia was diagnosed to have disseminated tuberculosis supported by the presence of caseating granuloma with Langhan's giant cells in the marrow and demonstration of acid-fast bacilli in the pleural fluid. Trilineage dysplasia from marrow aspirate was initially attributed to be reactive to the infection. A cytogenetic study was repeated after he showed poor response to a year of anti-tuberculosis treatment. The underlying primary myelodysplastic syndrome was unmasked when his cytogenetics showed trisomy 8. This case report has demonstrated the various haematological manifestations of tuberculosis and highlighted the importance of cytogenetic study in differentiating between primary and secondary myelodysplastic marrow changes.
    Matched MeSH terms: Diagnosis, Differential
  20. Wan Jamaludin WF, Periyasamy P, Wan Mat WR, Abdul Wahid SF
    J Clin Virol, 2015 Aug;69:91-5.
    PMID: 26209387 DOI: 10.1016/j.jcv.2015.06.004
    Infection associated hemophagocytic syndrome is increasingly recognized as a potentially fatal complication of dengue fever. It should be suspected with prolonged fever beyond seven days associated with hepatosplenomegaly, hyperferritinemia, worsening cytopenias and development of multiorgan dysfunction. Surge of similar pro-inflammatory cytokines observed in dengue associated hemophagocytic syndrome and multiorgan dysfunction may indicate they are part of related inflammatory spectrum. A proportion of patients recovered with supportive therapy, however most required interventions with corticosteroids, intravenous immunoglobulin or chemotherapy. We report three cases of dengue associated IAHS with good outcome following early recognition and treatment with dexamethasone and intravenous immunoglobulin.
    Matched MeSH terms: Diagnosis, Differential
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