Displaying publications 1 - 20 of 810 in total

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  1. Zurina Z, Rohani A, Neela V, Norlijah O
    PMID: 23413711
    Group B beta-hemolytic streptococcus (GBS) sepsis is a serious bacterial infection in neonates, with significant morbidity and mortality. We report here a neonate with late onset GBS infection manifesting as a urinary tract infection (UTI) in an infant presenting with prolonged neonatal jaundice. The pathogenesis of this late onset is postulated.
    Matched MeSH terms: Diagnosis, Differential
  2. Zulkifli MZ, Ho CC, Goh EH, Praveen S, Das S
    Clin Ter, 2012;163(1):23-5.
    PMID: 22362229
    Incidence of urolithiasis is on the rise due to climatic changes especially global warming.The pain due to presence of ureteric stone is a well known identity but many times it may be asymptomatic or even masked by concurrent presence of backache. In the present article, we describe the case of a 43-year-old male who came to the clinic for treatment of backache persisting for more than two years. The patient complained of backache two years back for which he was treated with analgesics and physiotherapy which relieved his pain. No X-ray was taken earlier because the attending clinician thought the backache to be musculo-skeletal in origin. Recently, one day a sudden episode of backache in the midst of night compelled him to seek medical treatment. However, this time a X-ray was performed and it showed the presence of calculi in the right upper pelvis of ureter which measured 1.9 cm vertically. An ultrasound confirmed the diagnosis. The patient was treated with two episodes of shock wave therapy which failed to crush the stone. A Double-J stent was inserted under general anaesthesia. The stone was crushed using a ureteroscope guided laser. The present case report describes how backache in professionals cannot be lightly attended. Even the characteristic groin to loin pain may be absent. All cases of backache should be properly investigated with an X-ray to rule out renal or ureteric calculi.
    Matched MeSH terms: Diagnosis, Differential
  3. Zulkiflee AB, Prepageran N, Philip R
    Am J Otolaryngol, 2008 Jan-Feb;29(1):72-4.
    PMID: 18061838 DOI: 10.1016/j.amjoto.2007.02.004
    INTRODUCTION: Melioidosis is a life-threatening disease caused by B. pseudomallei. It is endemic in Southeast Asia with a few reports from the Western world. It is transmitted via inhalation, ingestion or direct contact with an open wound. Clinically it may present with local or systemic symptoms. Mortality rate is very high in systemic disease; but local infection is usually mild, which causes delay in seeking medical attention.
    CASE REPORT: We report a case of neck melioidosis presenting as a parapharyngeal abscess that was successfully managed with incision and drainage and intravenous ceftazidime and co-trimoxazole for 6 weeks followed by eradication therapy with oral co amoxiclav.
    CONCLUSION: Neck melioidosis must be considered one of differential diagnoses for "cold abscesses" of the neck, especially in an endemic area, in Asian migrants, or in those with history of previous visit from the endemic regions.
    Matched MeSH terms: Diagnosis, Differential
  4. Zulkafli Z, Janaveloo T, Wan Ab Rahman WS, Hassan MN, Abdullah WZ
    Oman Med J, 2019 Jul;34(4):336-340.
    PMID: 31360323 DOI: 10.5001/omj.2019.65
    Thrombocytosis in children as well as in adult is defined as platelet count ≥ 450 × 109/L, and it is usually a reactive feature to various medical disorders. However, extreme thrombocytosis (platelet count ≥ 1000 × 109/L) is an uncommon finding among pediatric and adult patients, which may indicate more than a reactive phenomenon. We describe a case of a five-year-old boy who was admitted due to recurrent epistaxis. He had no history of allergic tendency or trauma. Physical examination was unremarkable except for shotty neck nodes. Laboratory results at presentation showed normal hemoglobin and total leukocyte count with eosinophilia (0.92 × 109/L), and extreme thrombocytosis. Other relevant investigations including coagulation profile, serum ferritin, liver, and renal function tests were all within normal ranges. Stool samples for ova and cysts were negative. The peripheral blood smear and bone marrow aspirate confirmed thrombocytosis with increased megakaryocytic proliferation and no artefactual reasons for the high platelets such as red blood cell fragments. Different causes of thrombocytosis in childhood were investigated after considering the possible differential diagnoses for extreme thrombocytosis.
    Matched MeSH terms: Diagnosis, Differential
  5. Zulfiqar MA, Zaleha AM, Zulkifli I, Chia WY, Samad SA
    Med J Malaysia, 1998 Sep;53(3):284-7.
    PMID: 10968168
    Three children aged 3-11 years had ultrasonography of the urinary tract for the investigation of dysuria and haematuria. A bladder mass was seen in these 3 children. One child had computed tomography scan, cystoscopy and bladder biopsy because rhabdomyosarcoma was considered. The biopsy revealed an inflammatory process. The urine culture of the other 2 children revealed E. coli. On ultrasonography, the inflammatory mass may appear homogeneously hypoechoic or may contain moderate level echoes. The mucosal surface of the mass may be smooth or lobulated. It is important to consider an infective cause for a bladder mass in children because computed tomography, cystoscopy and biopsy may be avoided.
    Matched MeSH terms: Diagnosis, Differential
  6. Zuhaimy H, Leow SN, Vasudevan SK
    BMJ Case Rep, 2017 Aug 09;2017.
    PMID: 28794092 DOI: 10.1136/bcr-2017-221170
    We discuss the diagnostic challenge in an adult patient presented with purely ocular symptoms diagnosed with tuberculous meningitis (TBM). A 38-year-old woman presented with bilateral painless blurring of vision. There were bilateral sixth cranial nerve palsy and bilateral optic disc swelling. Optic nerve function tests were normal. Patient was lucid with no signs of meningism. Brain imaging were normal. She had a positive Mantoux test, high erythrocyte sedimentation rate but no clinical evidence of active pulmonary tuberculosis infection. Her Quantiferon-TB Gold in-tube test was negative. Cerebrospinal fluid analysis revealed a high opening pressure but no biochemical parameters to suggest TBM, hence she was treated as idiopathic intracranial hypertension. A diagnosis of TBM was finally made following a positive PCR for Mycobacterium tuberculosis Her vision improved with reduction in optic disc swelling following antituberculous treatment.
    Matched MeSH terms: Diagnosis, Differential
  7. Zhang ZY, Yang WY, Dominiczak AF, Wang JG, Wu Y, Almustafa B, et al.
    Hypertension, 2019 11;74(5):1064-1067.
    PMID: 31422692 DOI: 10.1161/HYPERTENSIONAHA.119.13206
    Matched MeSH terms: Diagnosis, Differential
  8. Zarina AL, Jamil MA, Ng SP, Rohana J, Yong SC, Salwati S, et al.
    Med J Malaysia, 2006 Jun;61(2):260-2.
    PMID: 16898328 MyJurnal
    Recurrent spontaneous abortion, defined as three consecutive abortions, occurs in approximately 1% to 2% of couples. Although the cause is unknown in up to 50% of cases, about 5% of these couples are found to be a balanced translocation carrier. We report a case in which the mother was identified to be a translocation carrier following the birth of a baby with multiple congenital abnormalities.
    Matched MeSH terms: Diagnosis, Differential
  9. Zakaria MA, Abdullah JM, George JP, Mutum SS, Lee NN
    Med J Malaysia, 2006 Jun;61(2):229-32.
    PMID: 16898318 MyJurnal
    Third ventricular cavernous angiomas are rare vascular malformations of the brain. We report an eight-year old boy with a rare third ventricular cavernous angioma that hemorrhaged presenting with symptoms of acute hydrocephalus. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) showed a heterogenous ill-defined, solid and cystic intraventricular mass in the third ventricle which was mildly enhanced with contrast and there was associated hydrocephalus. The mass was removed with success and follow up after two years revealed no neurological abnormalities.
    Matched MeSH terms: Diagnosis, Differential
  10. Zakaria A, Sockalingam S
    Sains Malaysiana, 2013;42:89-91.
    Bullous impetigo is a highly contagious skin infection commonly affecting children due to epidermolytic toxins of bacteria Staphylococcus sp. This presentation described a case of a 3 year-old Indian girl with bullous lesion around the peri-oral region. The lesion was initially thought to be of viral origin and was treated symptomatically. However, the lesion progressed without any resolution with more vesicles at distant sites. The patient was also having fever and refused any oral intake. At this point, a probable diagnosis of bacterial skin infection was considered and the patient was admitted. Intra-venous fluid was administered to rehydrate the patient and she was treated with topical antibiotic and antipyretic. The lesion resolved within 14 days without scarring. As dental practitioners, we should be aware of bacterial infection around the peri-oral region and consider it as part of a differential diagnosis so that an appropriate treatment can be given.
    Matched MeSH terms: Diagnosis, Differential
  11. Zainudin BM, Kassim F, Annuar NM, Lim CS, Ghazali AK, Murad Z
    J Trop Med Hyg, 1992 Aug;95(4):276-9.
    PMID: 1495124
    A renal transplant patient presented with ileal perforation due to histoplasmosis 3 years after transplantation. Mesenteric lymph nodes and lungs were also affected by the disease. She was successfully treated with amphotericin B followed by ketoconazole.
    Matched MeSH terms: Diagnosis, Differential
  12. Zaini Anuar, Asrar M, Ngan A
    Med J Malaysia, 1982 Mar;37(1):78-9.
    PMID: 7121353
    A young Chinese female presented with severe bilateral chemosis without any other systemic evidence ofoedema or systemic lupus erythematosus (SLE). Investigations confirmed the diagnosis of SLE with early diffuse proliferative glomerulonephritis. The condition improved with steroid therapy.
    Matched MeSH terms: Diagnosis, Differential
  13. Zainal N, Kampan NC, Rose IM, Ghazali R, Shafiee MN, Yussoff NH, et al.
    Horm Mol Biol Clin Investig, 2021 May 21;42(3):311-316.
    PMID: 34018382 DOI: 10.1515/hmbci-2020-0086
    OBJECTIVES: Gestational trophoblastic disease comprises of a spectrum of pregnancy-related tumours which includes complete (CHM) and partial hydatidiform moles (PHM). Accurate diagnosis and subclassification of HM subtypes are crucial as prognosis differs. Histopathological examination using haemotoxylin and eosin (H&E) staining remains the basis for diagnosing HM, with only 80% accuracy. p57kip2 is a cyclin-dependent kinase inhibitor (CDKI) protein and is strongly paternally imprinted, being expressed from maternal allele. Therefore, complete mole (CHM) with only paternal genome has nearly absent expression of p57kip2 compared to partial mole (PHM) having both paternal and maternal genomes. This study is aimed to determine usefulness of p57kip2 immunohistochemistry (IHC) analysis in the diagnosis of HM subtypes.

    METHODS: A total of 82 archived paraffin embedded HM tissues with subtypes classified based on H&E staining - 39 (47.5%) CHM, 41 (50.0%) PHM and two (2.43%) unclassified molar pregnancy were retrieved. All tissue samples were subjected for p57kip2 IHC analysis and HM subtypes were then reclassified.

    RESULTS: A total of 66 cases (80.5%) were re-classified as CHM, 14 cases (17.1%) as PHM and two cases (2.4%) were decidual and cystic tissues. Analysis using p57kip2 immunostaining showed a diagnostic discrepancy of 33.0% from routine H&E staining and helps to improve the characterisation of the HM subtypes specifically at early gestations which have less distinctive morphologies.

    CONCLUSIONS: IHC using p57kip2 monoclonal antibody should be considered as a routine ancillary test to H&E in improving the diagnosis of HM subtypes particularly in developing countries with limited resources.

    Matched MeSH terms: Diagnosis, Differential
  14. Zainal Abidin SS, Kew TY, Azman M, Mat Baki M
    BMJ Case Rep, 2020 Dec 22;13(12).
    PMID: 33370978 DOI: 10.1136/bcr-2020-237129
    A 57-year-old male chronic smoker with underlying diabetes mellitus presented with dysphonia associated with cough, dysphagia and reduced effort tolerance of 3 months' duration. Videoendoscope finding revealed bilateral polypoidal and erythematous true and false vocal fold with small glottic airway. The patient was initially treated as having tuberculous laryngitis and started on antituberculous drug. However, no improvement was observed. CT of the neck showed erosion of thyroid cartilage, which points to laryngeal carcinoma as a differential diagnosis. However, the erosion was more diffuse and appeared systemic in origin. The diagnosis of laryngeal perichondritis was made when the histopathological examination revealed features of inflammation, and the tracheal aspirate isolated Pseudomonas aeruginosa The patient made a good recovery following treatment with oral ciprofloxacin.
    Matched MeSH terms: Diagnosis, Differential
  15. Zain R
    Med J Malaysia, 1986 Dec;41(4):370-3.
    PMID: 3670162
    This article consists of two selected case reports of a recently named odontogenic tumour, unicystic ameloblastoma. The clinical and radiographic findings of the two cases mimic that of odontogenic cysts but not dentigerous cysts as in most reported, cases. Histologically, either a normal or ameloblastomatous cyst lining is evident. Other features of ameloblastoma are present within the cyst wall or as luminal nodules within the cystic space. A review of the literature indicates that this is a non-aggressive tumour with a low recurrence rate.
    Matched MeSH terms: Diagnosis, Differential
  16. Zaifullah S, Yunus MR, See GB
    Eur Arch Otorhinolaryngol, 2013 Mar;270(4):1501-6.
    PMID: 23053382 DOI: 10.1007/s00405-012-2200-7
    Branchial cleft anomalies result from abnormal persistence of branchial apparatus, which is located at the lateral part of the neck. These occur due to failure of obliteration of the branchial apparatus during embryonic development. Differential diagnoses of lateral neck mass are salivary gland or neurogenic neoplasms, paragangliomas, adenopathies, cystic hygroma or cystic metastasis from squamous cell carcinoma or thyroid papillary carcinoma. Clinically, a branchial cyst is smooth, round, fluctuant and non-tender, and usually occurs over the upper part of the neck, anterior to the sternocleidomastoid muscle. Sometimes, it may present as infected cyst (or abscess), a sinus or fistula. Surgical excision is the definitive treatment for branchial anomalies. The objective of the work was to study the demographic data, clinical presentation, definite diagnostic workup and treatment of patients diagnosed with branchial anomalies. This is a retrospective study of 26 patients who were diagnosed with branchial anomalies (branchial cyst and fistula), of which only 12 patients had data available between July 1999 and June 2009 at the Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre. Twelve cases of branchial anomalies were seen, in which 10 patients had second branchial cyst anomalies, 1 had third branchial fistula and 1 had bilateral branchial lesion. There were seven females and five males. The age of the patients varied over a wide range (4-44 years), but the majority of the patients were in their second and third decade of life. All branchial anomalies occurred at the classical site; eight patients had left-sided neck lesion. Correct clinical diagnosis was made only in five patients (41.6 %). All patients underwent surgical excision with no reported recurrence. Branchial anomalies are frequently forgotten in the differential diagnosis of lateral neck swelling. Diagnosis is usually delayed, leading to improper treatment. The diagnosis of patients who present with lateral neck cystic swelling with or without episodes of recurrent neck abscess should be considered with a high suspicion for branchial anomalies. FNA cytology is a good investigative tool in reaching toward a diagnosis of branchial lesion, with the concurrent assistance of radiological modalities. Surgical excision is the gold standard treatment of lesions of branchial anomalies.
    Matched MeSH terms: Diagnosis, Differential
  17. Zahid M, Khan AH, Yunus ZM, Chen BC, Steinmann B, Johannes H, et al.
    J Pak Med Assoc, 2019 Mar;69(3):432-436.
    PMID: 30890842
    In spite of the efforts and interventions by the Government of Pakistan and The World Health Organization, the neonatal mortality in Pakistan has declined by only 0.9% as compared to the global average decline of 2.1% between 2000 and 2010. This has resulted in failure to achieve the global Millennium Development Goal 4. Hypoxic-ischaemic encephalopathy, still birth, sepsis, pneumonia, diarrhoea and birth defects are commonly attributed as leading causes of neonatal mortality in Pakistan. Inherited metabolic disorders often present at the time of birth or the first few days of life. The clinical presentation of the inherited metabolic disorders including hypotonia, seizure and lactic acidosis overlap with clinical features of hypoxic-ischaemic encephalopathy and sepsis. Thus, these disorders are often either missed or wrongly diagnosed as hypoxicischaemic encephalopathy or sepsis unless the physicians actively investigate for the underlying inherited metabolic disorders. We present 4 neonates who had received the diagnosis of hypoxic-ischaemic encephalopathy and eventually were diagnosed to have various inherited metabolic disorders. Neonates with sepsis and hypoxic-ischaemic encephalopathy-like clinical presentation should be evaluated for inherited metabolic disorders.
    Matched MeSH terms: Diagnosis, Differential
  18. Zahari M, Mohd Ali AK, Chandrasekharan S
    Singapore Med J, 1996 Jun;37(3):285-7.
    PMID: 8942231
    To determine the incidence of delayed intracranial haemorrhage and the indication for repeat computed tomography (CT), a one and a half year retrospective study was made. A total of 289 patients had CT scan for head injury of which 78 (26.9%) had multiple scans. Out of these, 5 patients developed delayed haemorrhages (one extradural, one subdural, and three intracerebral haematoma). The incidence of delayed intracranial haemorrhage in our series is small when compared with others. The main predisposing factors are decompressive surgery, hyperventilation and cerebral dehydration therapy. It is important to know when to repeat the CT scan. A review of the literature regarding this aspect is presented and compared with our protocol. Intracranial pressure monitoring plays an increasingly important role in the management of head injury and should be used to decide the patient requiring repeat CT. Follow-up CT without other indication is not necessary.
    Matched MeSH terms: Diagnosis, Differential
  19. Zabidi-Hussin ZA
    Adv Med Educ Pract, 2016;7:247-8.
    PMID: 27217805 DOI: 10.2147/AMEP.S106507
    Having an organized, structured thinking process is critical in medicine. It is through this thinking process that enables one to go through the method of history-taking, which will eventually lead to making a definitive diagnosis and all other processes that follow. The use of mnemonic has been found to be useful for this purpose. The mnemonic VITAMINSABCDEK, is a convenient and practical way to assist in expanding the differential diagnoses and covers all possible causes of an illness. It is also easy to remember, as the vitamins whose letters are represented in this mnemonic cover the entire range of vitamins known.
    Matched MeSH terms: Diagnosis, Differential
  20. Yusuf SYM, Ismail IA, Hamid RA, Jamil NA, Yasin MM
    Open Access Maced J Med Sci, 2019 Jun 15;7(11):1815-1817.
    PMID: 31316665 DOI: 10.3889/oamjms.2019.481
    BACKGROUND: Leprosy or Hansen disease is a chronic infectious disease that causes social stigma due to its deforming bodily appearance and physical disability. It has a wide spectrum of presentation affecting diagnosis.

    CASE REPORT: A 21-year-old man who presented with chronic isolated bilateral pinna swelling as a result of leprosy is reported. The bilateral pinna swelling started as multiple shiny papules with an erythematous background and progressively became hyperpigmented and lobular over two years. This rare presentation of leprosy poses initial diagnostic difficulties, leading to misdiagnoses by various health care professionals. Diagnoses ascribed include eczema, insect bite and perichondritis. A suspicion of leprosy was raised when hyperaesthetic hypopigmentation of skin started to appear on the body after two years, with worsening of the pinna swellings. This was confirmed by identification of Mycobacterium leprae in slit skin smear test and skin biopsy.

    CONCLUSION: Isolated involvement of pinna in a patient without lesions in other body parts is an unusual initial presentation of leprosy. However, leprosy should be kept as a rare differential diagnosis of isolated lesions on the ear in patients not responding to conventional treatment.

    Matched MeSH terms: Diagnosis, Differential
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