Displaying publications 1 - 20 of 808 in total

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  1. Basilar invagination: A mimicker of bulbar-onset amyotrophic lateral sclerosis
    Tan JSH, Lee S, Hiew FL
    eNeurologicalSci, 2021 Mar;22:100321.
    PMID: 33553704 DOI: 10.1016/j.ensci.2021.100321
    Amyotrophic lateral sclerosis (ALS) is characterized by progressive onset motor deficits with heterogenous presentations ranging from dysarthria to foot drop. Approximately 20% of the patients present with focal bulbar symptoms, in which some may remain restricted to bulbar region (isolated bulbar palsy), and the remaining eventually spreads to involve other body regions (classical ALS). Without accompanying upper and lower motor neurons signs elsewhere, differential diagnoses for isolated bulbar symptoms are extensive, include ALS variants as well as potentially treatable mimics. Therefore, it is important to take heed on every possible aetiology that may disrupt the hypoglossal nucleus, nerve, or lingual muscle itself. Herein, we illustrated a rare presentation of Group A basilar invagination, which mimicked bulbar-onset ALS.
    Matched MeSH terms: Diagnosis, Differential
  2. [Tropical sprue as the cause of chronic diarrhea after travel to Southeast Asia]
    Kirchgatterer A, Allinger S, Balon R, Tuppy H, Knoflach P
    Z Gastroenterol, 1998 Oct;36(10):897-900.
    PMID: 9846368
    A 43-year-old woman developed abdominal pain and diarrhea following a travel to Malaysia. Examinations in another hospital proved no evidence of infection, an empirical antibiotic therapy with ciprofloxacin yielded no benefit. One and a half year later, the patient was admitted to our department because of persistent diarrhea and wasting. Laboratory tests showed megaloblastic anemia, folate deficiency and steatorrhea. Stool specimens for bacterial pathogens and parasites were negative. Endoscopy and biopsy from the distal portion of the duodenum revealed broadening and shortening of the villi and an increased infiltration of the lamina propria by chronic inflammatory cells (plasma cells and lymphocytes). In conclusion, diagnosis of tropical sprue was established. The therapy comprised of tetracycline for six weeks and folic acid for six months. Subsequently, the diarrhea disappeared, the patient continuously gained weight and was free of any complaints. The complete remission following this regimen proved the suspected diagnosis. Differential diagnosis in any patient who recently returned from the tropics may be a challenge. Tropical sprue predominantly occurs during or after a longer stay in endemic areas. However, if chronic diarrhea and signs of malabsorption develop after a short journey to India, South-East Asia and parts of the Caribbean, tropical sprue has to be considered, too.
    Matched MeSH terms: Diagnosis, Differential
  3. Erythema nodosum
    Leung AKC, Leong KF, Lam JM
    World J Pediatr, 2018 Dec;14(6):548-554.
    PMID: 30269303 DOI: 10.1007/s12519-018-0191-1
    BACKGROUND: Erythema nodosum can be associated with a number of systemic diseases. There is, however, a paucity of information in the pediatric literature on this condition. The purpose of this article is to familiarize pediatricians with the evaluation, diagnosis, and treatment of erythema nodosum.

    DATA SOURCES: A PubMed search was completed in Clinical Queries using the key terms "erythema nodosum".

    RESULTS: Clinically, erythema nodosum presents with a sudden onset of painful, erythematous, subcutaneous nodules mainly localized to the pretibial areas. Lesions are usually bilateral and symmetrical, ranging from 1 to 5 cm in diameter. Erythema nodosum may be associated with a variety of conditions such as infection, medications, sarcoidosis, pregnancy, inflammatory bowel disease, vaccination, autoimmune disease, malignancy, and miscellaneous causes. The condition is idiopathic in approximately 50% of cases. The diagnosis is mainly clinical with biopsy reserved for atypical cases. To evaluate for the underlying cause, some basic laboratory screening studies are worthwhile in most cases and include a complete blood cell count, erythrocyte sedimentation rate and/or C-reactive protein, throat swab culture, antistreptococcal O titers, and a chest radiograph. Other tests should be individualized, guided by the history and physical examination results. Most cases of erythema nodosum are self-limited and require no treatment. Bed rest and leg elevation are generally recommended to reduce the discomfort. Nonsteroidal anti-inflammatory drugs are the first-line treatment for pain management.

    CONCLUSIONS: As erythema nodosum is often a cutaneous manifestation of a systemic disease, a thorough search should be performed to reveal the underlying cause.

    Matched MeSH terms: Diagnosis, Differential
  4. Fulltext Usefulness of a scoring system in the interpretation of histology in neonatal cholestasis
    Lee WS, Looi LM
    World J Gastroenterol, 2009 Nov 14;15(42):5326-33.
    PMID: 19908342 DOI: 10.3748/wjg.15.5326
    AIM: To ascertain the usefulness of a histological scoring system devised to assist in the interpretation of liver histology in neonatal cholestasis (NC).

    METHODS: Liver biopsy specimens obtained from infants with NC referred to a tertiary pediatric unit in Malaysia were prospectively studied. The first author, blinded to the final diagnosis, devised the histological diagnosis based on a 7-feature (portal ductal proliferation, bile plugs in portal ductules, porto-portal bridging, lymphocytic infiltration in portal region, multinucleated hepatocytes, neutrophilic infiltration, hepatocellular swelling), 15-point (0 to 15) scoring system. The author classified the histological diagnosis as either biliary atresia (BA) or neonatal hepatitis (NH, all other diagnoses), and subsequently compared the author's diagnosis with the final diagnosis.

    RESULTS: Eighty-four biopsy specimens obtained from 78 patients were reviewed. Without the scoring system, BA was correctly diagnosed by the author histologically in 30 cases, labelled as NH in 3. For other diagnoses, BA was excluded correctly in 33 cases and mislabeled as BA in 2 cases. The overall sensitivity for BA was 91%, specificity 86% and accuracy 88%. With the scoring system, a score of >or=7 had the best diagnostic utility to differentiate BA from other intrahepatic cholestasis histologically (sensitivity 88%, specificity 94%, accuracy 92%). Four patients with a score<7 had BA, and 3 patients with a score>or=7 had NH.

    CONCLUSION: A 7-feature, 15-point histological scoring system had good diagnostic accuracy in the interpretation of liver histology in neonatal cholestasis.
    Matched MeSH terms: Diagnosis, Differential
  5. Asymptomatic Balanced Double Aortic Arch Associated With Tetralogy of Fallot
    Haranal M, Abdul Latiff HB, Sivalingam S
    World J Pediatr Congenit Heart Surg, 2020 01;11(1):130-132.
    PMID: 31835984 DOI: 10.1177/2150135119885889
    Coexistence of asymptomatic balanced double aortic arch with tetralogy of Fallot (TOF) is extremely rare and represents a surgical dilemma in decision-making due to the lack of consensus on the management of this subset of patients. We report a case of asymptomatic balanced double aortic arch coexistent with TOF in a two-year-old girl.
    Matched MeSH terms: Diagnosis, Differential
  6. Leptospirosis in a caver returned from Sarawak, Malaysia
    Mortimer RB
    Wilderness Environ Med, 2005;16(3):129-31.
    PMID: 16209467
    This article describes a case of leptospirosis in a man who returned from caving in Sarawak, Malaysia, and includes a discussion of epidemiology, pathophysiology, diagnosis, prevention, and treatment. The patient presented with symptoms of leptospirosis, which was confirmed by microhemagglutination titers. He became infected despite taking doxycycline daily for malaria prophylaxis. Leptospirosis is an important consideration in any returned traveler with fever. The spirochete spreads from animals to humans via water. Caving in tropical endemic zones may increase exposure risk due to the combination of multiple skin abrasions with immersions. Water in caves may increase infection risk because of increased water pH. Standard prophylaxis may be inadequate in cases of high-risk exposures.
    Matched MeSH terms: Diagnosis, Differential
  7. [Primary liver carcinoma. Review]
    Korenek J
    Vnitr Lek, 1970 Apr;16(4):371-8.
    PMID: 4910163
    Matched MeSH terms: Diagnosis, Differential
  8. Fulltext First case report on the occurrence of Trypanosoma evansi in a Siam B Mare in Kelantan, Malaysia
    Mohd Rajdi NZI, Mohamad MA, Tan LP, Choong SS, Reduan MFH, Hamdan RH, et al.
    Vet Med Sci, 2021 Mar;7(2):303-309.
    PMID: 33161648 DOI: 10.1002/vms3.379
    This is the first case report for the positive Trypanosoma evansi incident in Kelantan, Malaysia confirmed through protozoa detection in a Siam B mare. The horse was presented with complaints of lethargy and inappetence and it collapsed on the day of visit. Normal saline and dextrose solution were administered intravenously, while multivitamins and nerve supplements were given intramuscularly to stabilise the horse before further treatment. Haematological findings showed normocytic hypochromic anaemia and are suggestive of regenerative anaemia. Thin blood smear and examination revealed the presence of Trypanosoma sp., and it was confirmed as T. evansi through molecular identification. The horse was found dead 2 days after and post-mortem was conducted. Histopathology revealed that the horse had developed a neurological form of the disease, besides the detection of the protozoa in heart, spleen and kidney tissue. This first positive Surra case in Kelantan, Malaysia, that is bordering Thailand confirms the increasing concern of transboundary infections. In conclusion, Surra is a potential emerging disease and should be considered as differential diagnosis in horses with pale mucous membrane. This condition is particularly imperative in horses found in these regions as Surra is endemic.
    Matched MeSH terms: Diagnosis, Differential
  9. Fulltext Imaging modalities for an uncommon inguinal scrotal pathology: A case report and literature review
    Chun KH, Inn FX, Hing EY, Hong GE
    Urol Ann, 2017 11 10;9(4):387-389.
    PMID: 29118545 DOI: 10.4103/UA.UA_69_17
    Inguinal scrotal swelling is a common presentation to surgical clinic with various differential diagnoses. In most circumstances, a good clinical assessment is sufficient to identify the diagnosis. Imaging is necessary when diagnostic difficulty was encountered. The choice of imaging study could affect the management and outcome. A 60-year-old male presented with an enlarging right inguinal scrotal swelling for 5 years. Clinical examination showed a swelling extended from the right inguinal region down to the right scrotum, firm, not reducible, and not separable from the right testis. Differential diagnoses range from the malignant testicular tumor, irreducible inguinal hernia to the soft-tissue tumor. Ultrasonography and computed tomography scan were unable to conclude the origin of the tumor and involvement of the right testis. Inguinal exploration with potential radical orchiectomy was planned and caused much distress to the patient, resulted in delay in surgery. Intraoperatively, the mass was separated from the testis and spermatic cord, and thus, excision biopsy was performed sparing the testis and spermatic cord. Histopathological examination showed cellular angiofibroma. The right choice of imaging modality is important to provide a precise diagnosis and better treatment plan. This could avoid the unnecessary distress to the patient for potential organ lost. A review through the literature showed the ability of magnetic resonance imaging to better delineate the anatomy of inguinal scrotal soft-tissue mass and thus should have been the imaging modality of choice.
    Matched MeSH terms: Diagnosis, Differential
  10. [A case of chronic schistosomiasis four years after infestation]
    Pedalino M, Vercesi E, Manini C, Piras D, Di Primio OG, Vella R, et al.
    Urologia, 2010 Oct-Dec;77 Suppl 17:38-41.
    PMID: 21308673
    Authors present a case of bilharziosis incidentally diagnosed in a patient undergoing TURB for suspected bladder cancer. The patient, who in 2005 had gone to Malaysia, had been suffering from recurrent hemorrhagic cystitis since 2007, which were treated with antibiotic therapy. In November 2009 he presented to our observation for persistent hematuria, underwent ultrasound examination, fibroscopy and TURB diagnostics for suspicious lesions. The histopathology diagnosis found granulomatous lesions with typical parasites eggs due to schistosomiasis eggs. As a consequence of that, the patient underwent medical therapy. The pathologist's role becomes nullifying not only for the diagnosis of parasitic infections but also for the exclusion or evidence of urothelial squamous neoplasia. The low incidence of this rare parasitic disease in European tourists and the presence of immigrants in our country require to spread the knowledge of these parasites and the most simple tests for early detection.
    Matched MeSH terms: Diagnosis, Differential
  11. Fulltext Closed reduction of traumatic bilateral anterior hip dislocations with sedation: a case report and review of the literature
    Chiu CK, Ng TS, Wazir NN, Bhurhanudeen KA
    Ulus Travma Acil Cerrahi Derg, 2015 Jan;21(1):63-7.
    PMID: 25779715 DOI: 10.5505/tjtes.2015.27475
    A rare case of bilateral anterior hip dislocation reduced under sedation was reported in this study. A 47-year-old man was knocked down by a car and sustained bilateral anterior hip dislocation which was reduced successfully with sedation using titrated dose of intravenous Midazolam in combination with Pethidine. A modified Lefkowitz maneuver using the manipulator's thigh as a fulcrum was used. Patient started weight bearing in the second month after injury and was walking without any hip pain at the twenty-fourth month follow-up. Thirteen case reports describing bilateral anterior hip dislocations were found while reviewing the literature and it was noticed that only one author had reported the usage of intravenous sedation (Propofol) for the reduction procedure. However, no author reported the use of Lefkowitz maneuver for this purpose. Consequently, reduction of a bilateral anterior hip dislocation is possible with sedation using a modified Lefkowitz maneuver.
    Matched MeSH terms: Diagnosis, Differential
  12. Semi-quantitative and qualitative assessment of breast ultrasound elastography in differentiating between malignant and benign lesions
    Alhabshi SM, Rahmat K, Abdul Halim N, Aziz S, Radhika S, Gan GC, et al.
    Ultrasound Med Biol, 2013 Apr;39(4):568-78.
    PMID: 23384468 DOI: 10.1016/j.ultrasmedbio.2012.10.016
    The purpose of this study was to evaluate the diagnostic value of qualitative and semi-quantitative assessment of ultrasound elastography in differentiating between benign and malignant breast lesions. This prospective study was conducted in two tertiary medical centers. Consecutive B-mode ultrasound and real-time elastographic images were obtained for 67 malignant and 101 benign breast lesions in 168 women. Four experienced radiologists analyzed B-mode ultrasound alone and B-mode ultrasound combined with elastography independently. Conventional ultrasound findings were classified according to the American College of Radiology Breast Imaging Reporting and Data System classification. The elastographic assessment was based on qualitative and semi-quantitative parameters (i.e., strain pattern, width ratio, strain ratio). The sensitivity and specificity of combined elastography and conventional ultrasound were significantly higher than that of conventional ultrasound alone. The sensitivity, specificity, positive predictive value and negative predictive value was 97%, 61.4%, 62.5% and 96.8%, respectively, for conventional ultrasound and 100%, 93%, 99% and 90%, respectively, for combined technique. The semi-quantitative assessment with strain ratio and width ratio in elastography were the most useful parameters in differentiating between benign and malignant breast lesions. Cut-off point values for width ratio of more than 1.1 and strain ratio of more than 5.6 showed a high predictive value of malignancy with specificities of 84% and 76%, respectively (p 
    Matched MeSH terms: Diagnosis, Differential
  13. Fusion of spatial gray level dependency and fractal texture features for the characterization of thyroid lesions
    Raghavendra U, Rajendra Acharya U, Gudigar A, Hong Tan J, Fujita H, Hagiwara Y, et al.
    Ultrasonics, 2017 05;77:110-120.
    PMID: 28219805 DOI: 10.1016/j.ultras.2017.02.003
    Thyroid is a small gland situated at the anterior side of the neck and one of the largest glands of the endocrine system. The abrupt cell growth or malignancy in the thyroid gland may cause thyroid cancer. Ultrasound images distinctly represent benign and malignant lesions, but accuracy may be poor due to subjective interpretation. Computer Aided Diagnosis (CAD) can minimize the errors created due to subjective interpretation and assists to make fast accurate diagnosis. In this work, fusion of Spatial Gray Level Dependence Features (SGLDF) and fractal textures are used to decipher the intrinsic structure of benign and malignant thyroid lesions. These features are subjected to graph based Marginal Fisher Analysis (MFA) to reduce the number of features. The reduced features are subjected to various ranking methods and classifiers. We have achieved an average accuracy, sensitivity and specificity of 97.52%, 90.32% and 98.57% respectively using Support Vector Machine (SVM) classifier. The achieved maximum Area Under Curve (AUC) is 0.9445. Finally, Thyroid Clinical Risk Index (TCRI) a single number is developed using two MFA features to discriminate the two classes. This prototype system is ready to be tested with huge diverse database.
    Matched MeSH terms: Diagnosis, Differential
  14. Schizophrenia or frontotemporal dementia in a young Chinese female: a purview of possible diagnoses
    Grewal GS, Kanagasundram S, Jambunathan S
    Turk Psikiyatri Derg, 2011;22(4):266-8.
    PMID: 22143952
    Frontotemporal dementia (FTD) is now increasingly being recognized as one of the causes of young onset dementia (YOD). The presentation of FTD can be subtle with a broad range of symptoms. This frequently causes misdiagnosis and a delay in initiating the correct treatment. While subtle personality changes, disinhibition and problems in executive functioning are frequently encountered in FTD, frank psychotic symptoms resembling schizophrenia are unusual. This is a case of a 38 year old Chinese female that highlights how obsessive compulsive symptoms which progressed to florid psychosis and disorganized speech and behavior can be a presenting picture in FTD. For seven years, this patient was treated as a case of schizophrenia and was thought to have poor response to electroconvulsive therapy (ECT) as well as antipsychotic medication. Her blood work and electroencephalogram (EEG) were normal. Magnetic resonance imaging (MRI) showed progressive cerebral atrophy. This case report suggests that psychosis should be investigated in detail especially when the clinical presentation is not typical of a functional disorder and more so when the patient is not responsive to conventional treatment. This report also highlights the importance of eliciting symptoms suggestive of an "organic" etiology, such as incontinence and disorientation. In addition, the usefulness of repeated imaging to show the rapidly progressive course of FTD has been illustrated. Other possible differential diagnoses of this patient are also discussed.
    Matched MeSH terms: Diagnosis, Differential
  15. Fulltext Congenital mature cystic teratoma of the lateral neck presenting as cystic hygroma: a rare case report with literature review
    Win TT, Razy N, Hamid S, Ubramanian AB, Ramalinggam G
    Turk Patoloji Derg, 2014;30(3):220-4.
    PMID: 24715558 DOI: 10.5146/tjpath.2013.01220
    Teratoma of the neck is a rare extra-gonadal teratoma. Although it can be seen in adult, most of the cases present in fetal life or early childhood. Grading and classification of teratoma is important for management and prognosis. Decision making between mature and immature teratoma is sometime challenging if it is not composed of extensive unusual neuroectodermal tissue component. We reported a rare case of huge congenital mature cystic teratoma composted of various neuroectodermal tissues in an 8-month-old boy; it was located at the lateral neck and mimicked congenital cystic hygroma. A literature review was done to grade and classify the tumour.
    Matched MeSH terms: Diagnosis, Differential*
  16. Plasmodium vivax malaria presenting as acute respiratory distress syndrome: a case report
    Rahman AK, Sulaiman FN
    Trop Doct, 2013 Apr;43(2):83-5.
    PMID: 23796679 DOI: 10.1177/0049475513485733
    Severe pulmonary involvement in malaria has been frequently reported in cases of Plasmodium falciparum infection but rarely in vivax malaria. We look at a case of a 38-year-old man living in a malaria endemic area who presented with acute respiratory distress syndrome (ARDS) caused by P. vivax. DNA polymerase chain reaction (PCR) confirmed that it was not a mixed infection. After specific antimalarial therapy and intensive supportive care, the patient was discharged from the hospital. This case illustrates that P. vivax-induced ARDS is not uncommon and should be readily recognized by the treating physicians. A confirmatory test with PCR is required in order to exclude P. falciparum co-infection.
    Matched MeSH terms: Diagnosis, Differential
  17. Dengue encephalitis: an entity now common in dengue-prone regions
    Matlani M, Chakravarti A, Rawal A, Kashyap B, Gurtoo A
    Trop Doct, 2009 Apr;39(2):115-6.
    PMID: 19299303 DOI: 10.1258/td.2008.080257
    As well as dengue fever (DF) and dengue haemorrhagic fever-dengue shock syndrome (DHF/DSS), other atypical manifestations of dengue virus infection have also been reported. The frequency of CNS involvement in dengue remains unknown, although isolated cases with neurological manifestations have been reported in Southeast Asia, Malaysia, Burma, Puerto Rico and India. We present two cases of encephalitis associated with DF and DHF from New Delhi, India.
    Matched MeSH terms: Diagnosis, Differential
  18. Appendicitis despite previous appendicectomy
    Moissinac K, To BC, Gul YA, Liew NC
    Trop Doct, 2001 Oct;31(4):217.
    PMID: 11676058
    Matched MeSH terms: Diagnosis, Differential
  19. Pre-operative identification of the level of obstruction in non-apnoeic snoring
    Raman R, Gopalakrishnan G
    Trop Doct, 1999 Jul;29(3):160-1.
    PMID: 10448240
    Matched MeSH terms: Diagnosis, Differential
  20. Haematoma testes due to traditional massage in a neonate
    Ram SP, Kyaw K, Noor AR
    Trop Doct, 1994 Apr;24(2):81-2.
    PMID: 8009626
    Matched MeSH terms: Diagnosis, Differential
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