Displaying publications 201 - 220 of 564 in total

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  1. Stature Estimation from Lower Limb Anthropometry using Linear Regression Analysis: A Study on the Malaysian Population
    Abu Bakar SN, Aspalilah A, AbdelNasser I, Nurliza A, Hairuliza MJ, Swarhib M, et al.
    Clin Ter, 2017 Mar-Apr;168(2):e84-e87.
    PMID: 28383619 DOI: 10.7417/CT.2017.1988
    INTRODUCTION: Stature is one of the characteristics that could be used to identify human, besides age, sex and racial affiliation. This is useful when the body found is either dismembered, mutilated or even decomposed, and helps in narrowing down the missing person's identity.

    AIM: The main aim of the present study was to construct regression functions for stature estimation by using lower limb bones in the Malaysian population.

    MATERIALS AND METHODS: The sample comprised 87 adult individuals (81 males, 6 females) aged between 20 to 79 years. The parameters such as thigh length, lower leg length, leg length, foot length, foot height and foot breadth were measured. They were measured by a ruler and measuring tape. Statistical analysis involved independent t-test to analyse the difference between lower limbs in male and female. The Pearson's correlation test was used to analyse correlations between lower limb parameters and stature, and the linear regressions were used to form equations. The paired t-test was used to compare between actual stature and estimated stature by using the equations formed.

    RESULTS: Using independent t-test, there was a significant difference (p< 0.05) in the measurement between males and females with regard to leg length, thigh length, lower leg length, foot length and foot breadth. The thigh length, leg length and foot length were observed to have strong correlations with stature with p= 0.75, p= 0.81 and p= 0.69, respectively. Linear regressions were formulated for stature estimation. Paired t-test showed no significant difference between actual stature and estimated stature.

    CONCLUSIONS: It is concluded that regression functions can be used to estimate stature to identify skeletal remains in the Malaysia population.
  2. The Role of Atypical Antipsychotics in Sexuality: Road to Recovery in Schizophrenia
    Adam RL, Sidi H, Midin M, Zakaria H, Das S, Mat KC
    Curr Drug Targets, 2018;19(12):1402-1411.
    PMID: 28464773 DOI: 10.2174/1389450118666170502130126
    Sexuality is an important dimension in human beings as a form of expression of individuality. For many decades, sexual functioning has been a neglected area among patients suffering from schizophrenia. It was a presumption that patients with schizophrenia could be asexual and this could be secondary to overwhelming situations of delusion, hallucination, hostility and negative symptoms among others. The deficient in sexual functioning are due to innate factors, i.e. negative symptoms (apathy, avolition and amotivation) and also as a result of prefrontal dysfunction, i.e. inability to plan and execute meaningful relationship. Adverse effects of the psychopharmacological agents, especially the typical antipsychotics, e.g. dystonia, excessive sedation and hyperprolactinemia may interfere with patients' sexual activity. In this review, we highlight the neurobiology of schizophrenia in the context of understanding sexual functioning and to integrate the knowledge of dopamine-serotonin neurotransmitter's interaction and the receptors' target. Interventional approaches consist of psychopharmacological and psychosocial interventions. In the perspective of sexuality, we recommend atypical antipsychotic should be placed as the first line treatment for both drug naïve patients and also to patients who are already receiving psychopharmacological agents in consideration for a drug-switch from typical to atypical antipsychotics. Aripiprazole, clozapine, olanzapine and quetiapine exert benefits in terms of sexual functioning recovery due to their atypical mechanism of action. However, the potential adverse effect like metabolic syndrome should be adequately managed to prevent negative consequences. Psychosocial interventions, i.e. psychoeducation, destigmatization, supportive psychotherapy and psychiatric rehabilitation also play a crucial role in the management. In conclusion, restoration of sexual function is an achievable recovery target in patients with schizophrenia through these biopsycho- social interventions.
  3. Kratom and Future Treatment for the Opioid Addiction and Chronic Pain: Periculo Beneficium?
    Ismail I, Wahab S, Sidi H, Das S, Lin LJ, Razali R
    Curr Drug Targets, 2019;20(2):166-172.
    PMID: 28443503 DOI: 10.2174/1389450118666170425154120
    Kratom (Mitragyna speciosa), a naturally existing plant found in South-East Asia, is traditionally used as a herb to help elevate a person's energy and also to treat numerous medical ailments. Other than the analgesic property, kratom has been used as an agent to overcome opioid withdrawal as it contains natural alkaloids, i.e. mitragynine, 7-hydroxymitragynine, and MGM-9, which has agonist affinity on the opioid receptors, including mu (µ) and kappa (κ). The role of neural reward pathways linked to µ-opioid receptors and both dopaminergic and gamma-Aminobutyric acid (GABA)-ergic interneurons that express µ-opioid receptors were deliberated. However, kratom has been reported to be abused together with other illicit substances with high risk of potential addiction. There are also anecdotes of adverse effects and toxicity of kratom, i.e. tremor, fatigue, seizure, and death. Different countries have distinctive regulation and policy on the plantation and use of this plant when most of the countries banned the use of it because of its addiction problems and side effects. The aim of this review is to highlight on the potential use of kratom, unique 'herbs" as a substitution therapy for chronic pain and opioid addiction, based on the neurobiological perspective of pain and the underlying mechanism of actions of drug addiction.
  4. The Novelty of Bupropion As a Dopaminergic Antidepressant for the Treatment of Adult Attention Deficit Hyperactive Disorder
    Deang KT, Sidi H, Zakaria H, Adam RL, Das S, Hatta NH, et al.
    Curr Drug Targets, 2019;20(2):210-219.
    PMID: 28494748 DOI: 10.2174/1389450118666170511145628
    Attention deficit hyperactive disorder (ADHD), a hyperactivity disorder prevalent among children may continue as an adulthood attention deficit. To date, treating an individual with an adult ADHD may be an arduous task as it involves numerous challenges, which include a need for high index of suspicion to diagnose this medical condition. Many psychiatric disorders masquerade as ADHD and delay the necessary assessment and proper treatment for this debilitating medical disorder. Adult ADHD is often misdiagnosed (or under diagnosed) due to the fact that this medical condition is being masked by the patients' high level of intellectual achievement. As the ADHD in adult persists, it may end-up with impairment in the personal-social-occupational function in which the management becomes a great challenge. The treatment of ADHD can be optimized by using various drugs targets agents like norepinephrine-dopamine reuptake inhibitor (NDRI), with or without psycho stimulants like methylphenidate, which is marketed as Ritalin. Bupropion, an NDRI has a novel effect on ADHD as the molecule exerts its effects by modulating the reward-pleasure mesolimbic dopaminergic system and at the same time regulates the elevating mood dimension of the noradrenergic neurotransmission. The role of Bupropion in the neural and psychopharmacological perspective treatment of ADHD was deliberated. The present review highlights the novel effects of Bupropion in ADHD treatment, together with the help of other successful bio-psycho-social measures. This may be of immense benefit to the psychiatrists for treating their patients.
  5. Histopathologic Findings in the Placentas of Pregnant Women With COVID-19
    Ahmad MF, Das S, Goldstein JA, Shanes ED, Mithal LB, Miller ES
    Am J Clin Pathol, 2021 07 06;156(2):329-330.
    PMID: 34145875 DOI: 10.1093/ajcp/aqab079
  6. Fulltext Targeting Probiotics in Rheumatoid Arthritis
    Bungau SG, Behl T, Singh A, Sehgal A, Singh S, Chigurupati S, et al.
    Nutrients, 2021 Sep 26;13(10).
    PMID: 34684377 DOI: 10.3390/nu13103376
    Rheumatoid arthritis (RA) is a progressive inflammatory disorder characterized by swollen joints, discomfort, tightness, bone degeneration and frailty. Genetic, agamogenetic and sex-specific variables, Prevotella, diet, oral health and gut microbiota imbalance are all likely causes of the onset or development of RA, perhaps the specific pathways remain unknown. Lactobacillus spp. probiotics are often utilized as relief or dietary supplements to treat bowel diseases, build a strong immune system and sustain the immune system. At present, the action mechanism of Lactobacillus spp. towards RA remains unknown. Therefore, researchers conclude the latest analysis to effectively comprehend the ultimate pathogenicity of rheumatoid arthritis, as well as the functions of probiotics, specifically Lactobacillus casei or Lactobacillus acidophilus, in the treatment of RA in therapeutic and diagnostic reports. RA is a chronic inflammation immunological illness wherein the gut microbiota is affected. Probiotics are organisms that can regulate gut microbiota, which may assist to relieve RA manifestations. Over the last two decades, there has been a surge in the use of probiotics. However, just a few research have considered the effect of probiotic administration on the treatment and prevention of arthritis. Randomized regulated experimental trials have shown that particular probiotics supplement has anti-inflammatory benefits, helps people with RA enhance daily activities and alleviates symptoms. As a result, utilizing probiotic microorganisms as therapeutics could be a potential possibility for arthritis treatment. This review highlights the known data on the therapeutic and preventative effects of probiotics in RA, as well as their interactions.
  7. Beneficial effects of natural products on female sexual dysfunction: A systematic review and meta-analysis
    Sha'ari N, Woon LS, Sidi H, Das S, Bousman CA, Mohamed Saini S
    Phytomedicine, 2021 Dec;93:153760.
    PMID: 34638031 DOI: 10.1016/j.phymed.2021.153760
    BACKGROUND: Female sexual dysfunction (FSD) includes female orgasmic disorder, female sexual interest or arousal disorder, and genito-pelvic pain or penetration disorder. FSD affects 40% of women worldwide, but it is understudied and likely undertreated. Natural products are frequently used by women to treat FSD, but scientific evidence of their efficacy is lacking.

    OBJECTIVE: This systematic review and meta-analysis focused on the study of the efficacy of natural products on FSD.

    STUDY DESIGN: Systematic review and meta-analysis of existing studies on natural products in the treatment of FSD.

    METHODS: The literature search included MEDLINE, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trial databases for studies published from January 2000 to February 2020. The quality and the level of evidence of the studies were assessed. The association between natural products and FSD was summarized using standardized mean differences (SMD) with a 95% confidence interval (CI).

    RESULTS: A total of 536 studies were identified, with 20 of them meeting the criteria. According to this meta-analysis, Tribulus terrestris showed a significant positive effect in improving overall female sexual function (SMD = 1.12, 95% CI = 0.46 - 1.79, p = 0.001) and individual sexual arousal (SMD = 1.03, 95% CI = 0.22 - 1.84, p = 0.013), sexual desire (SMD = 1.08, 95% CI = 0.52 - 1.63, p ≤ 0.001) and sexual orgasm (SMD = 0.51, 95% CI = 0.02 - 1.00, p = 0.040) domains compared to placebo. Panax ginseng was found to be effective in treating sexual arousal (SMD = 0.54, 95% CI = 0.11 - 0.97, p = 0.014) and sexual desire (SMD = 0.59, 95% CI = 0.27 - 0.90, p < 0.001) compared to placebo. Meanwhile, other natural products reviewed in this study, such as Trifolium pretense, did not differ significantly from placebo in terms of improving FSD.

    CONCLUSION: Preliminary evidence suggests that Tribulus terrestris and Panax ginseng may be effective as alternative treatments for FSD in a clinical setting.

  8. Fulltext Artemisinin combination therapy fails even in the absence of Plasmodium falciparum kelch13 gene polymorphism in Central India
    Das S, Kar A, Manna S, Mandal S, Mandal S, Das S, et al.
    Sci Rep, 2021 05 11;11(1):9946.
    PMID: 33976269 DOI: 10.1038/s41598-021-89295-0
    Artemisinin is the frontline fast-acting anti-malarial against P. falciparum. Emergence and spread of resistant parasite in eastern-India poses a threat to national malaria control programs. Therefore, the objective of our study is to evaluate the artesunate-sulfadoxine-pyrimethamine efficacy in Central India. 180 monoclonal P. falciparum-infected patients received standard ASSP therapy during August 2015-January 2017, soon after diagnosis and monitored over next 42-days. Artemisinin-resistance was assessed through in-vivo parasite clearance half-life (PC1/2), ex-vivo ring-stage survivability (RSA), and genome analysis of kelch13 and other candidate gene (pfcrt, pfmdr1, pfatpase 6, pfdhfr and pfdhps). Of 180 P. falciparum positive patients, 9.5% showed increased PC1/2 (> 5.5 h), among them eleven isolates (6.1%) showed reduced sensitivity to RSA. In 4.4% of cases, parasites were not cleared by 72 h and showed prolonged PC1/2(5.6 h) (P 
  9. Fulltext Intraoperative cerebral oximetry in open heart surgeries reduced postoperative complications: A retrospective study
    Juliana N, Abu Yazit NA, Kadiman S, Muhammad Hafidz K, Azmani S, Mohd Fahmi Teng NI, et al.
    PLoS One, 2021;16(5):e0251157.
    PMID: 34038405 DOI: 10.1371/journal.pone.0251157
    Cardiothoracic surgeries are life-saving procedures but often it results in various complications. Intraoperative cerebral oximetry monitoring used to detect regional cerebral oxygen saturation (rScO2) is a non-invasive method that provides prognostic importance in cardiac surgery. The main aim of the present study was to evaluate the association of intraoperative cerebral oxygen monitoring during cardiac surgery on postoperative complications. This was a case-controlled retrospective study conducted on adult patients, who underwent open-heart surgery in National Heart Institute, Malaysia. The case group comprised patients on protocolized cerebral oximetry monitoring. They were treated using a standardized algorithm to maintain rScO2 not lower than 20% of baseline rScO2. The control group comprised patients with matched demographic background, preoperative risk factors, and type of surgical procedures. Propensity score stratification was utilized to contend with selection bias. Retrospective analysis was performed on 240 patients (case group) while comparing it to 407 patients (control group). The non-availability of cerebral oximetry monitoring during surgery was the prominent predictor for all outcome of complications; stroke (OR: 7.66), renal failure needing dialysis (OR: 5.12) and mortality (OR: 20.51). Postoperative complications revealed that there were significant differences for risk of mortality (p<0.001, OR = 20.51), renal failure that required dialysis (p<0.001, OR = 5.12) and stroke (p <0.05, OR = 7.66). Protocolized cerebral oximetry monitoring during cardiothoracic surgeries was found to be associated with lower incidence of stroke, renal failure requiring dialysis and mortality rate.
  10. Fulltext Natural Product-based Nanomedicine: Recent Advances and Issues for the Treatment of Alzheimer's Disease
    Woon CK, Hui WK, Abas R, Haron MH, Das S, Lin TS
    Curr Neuropharmacol, 2022;20(8):1498-1518.
    PMID: 34923947 DOI: 10.2174/1570159X20666211217163540
    Alzheimer's disease (AD) affects the elderly and is characterized by progressive neurodegeneration caused by different pathologies. The most significant challenges in treating AD include the inability of medications to reach the brain because of its poor solubility, low bioavailability, and the presence of the blood-brain barrier (BBB). Additionally, current evidence suggests the disruption of BBB plays an important role in the pathogenesis of AD. One of the critical challenges in treating AD is the ineffective treatments and their severe adverse effects. Nanotechnology offers an alternative approach to facilitate the treatment of AD by overcoming the challenges in drug transport across the BBB. Various nanoparticles (NP) loaded with natural products were reported to aid in drug delivery for the treatment of AD. The nano-sized entities of NP are great platforms for incorporating active materials from natural products into formulations that can be delivered effectively to the intended action site without compromising the material's bioactivity. The review highlights the applications of medicinal plants, their derived components, and various nanomedicinebased approaches for the treatment of AD. The combination of medicinal plants and nanotechnology may lead to new theragnostic solutions for the treatment of AD in the future.
  11. Iatrogenic inguinal chyle fistula: a rare case report
    Zubaidah NH, Jasmi AY, Hanafiah H, Shaker AH, Asri CM, Emad AR, et al.
    Rom J Morphol Embryol, 2012;53(2):431-2.
    PMID: 22732820
    Chyle fistula may be common in the neck and thorax region but it is a rare entity in the inguinal region. The rarity of the incidence of chyle fistula and the tremendous response to conservative management are the important aspects to be remembered. We hereby report a case of iatrogenic inguinal chyle fistula complicating a femoral vein cannulation.
  12. A study of JAK2 (V617F) gene mutation in patients with chronic myeloproliferative disorders
    Hamidah NH, Farisah NR, Azlinda AB, Wong FL, Das S, Fadillah SA, et al.
    Clin Ter, 2012;163(2):109-13.
    PMID: 22555824
    Chronic myeloproliferative diseases (MPDs) are heterogenous group of haematological malignant disorders. It is now a well recognized fact that the JAK2 (V617F) mutation occurs in majority of the patients with polycythaemia vera (PV) and half of those with myelofibrosis and essential thrombocythaemia. The presence of JAK2 (V617F) mutation is considered an important criterion for the exclusion of secondary-reactive from clonal disorders. In the present uni-institutional study, we analyzed the JAK2 (V617F) mutation status in the ethnic Malay and Chinese patients who were diagnosed as MPDs.
  13. Atypical (symplastic) leiomyoma of the uterus--a case report
    Siti-Aishah MA, Noriah O, Malini MN, Zainul-Rashid MR, Das S
    Clin Ter, 2011;162(5):447-50.
    PMID: 22041803
    A 30-year-old, nulliparous woman presented with a history of subfertility. On examination she was found to have uterine fibroid of 28 weeks size of gravid uterus and subsequently laporatomy myomectomy was performed. Multilobulated masses, with diameters ranging from 22 mm to 160 mm were found. Cut sections of the lobulated masses showed whitish whorled cut surface. One of the multilobulated masses had a cystic cavity, measuring 60x50x35 mm(3). Light microscopic findings of the mass with the cystic cavity showed a well-circumscribed cellular tumour composed of cells exhibiting moderate nuclear atypia which were enlarged, nuclei with prominent chromatin clumping and were distributed in areas. Some tumour cells showed large nuclear pseudoinclusions, multinucleated or multilobated tumour giant cells, smudging and few enlarged nucleoli. Mitotic activity was 4 MFs per 10 HPFs. Occasional cells with intracytoplasmic inclusions resembling rhabdoid - like features were seen. There were no atypical mitoses or tumour necroses were noted. Diagnosis of atypical leiomyoma or symplastic leiomyoma was made. Atypical or symplastic leiomyomas are rare in the region of Malaysia and the present case discusses its incidence in younger age, its morphological features along with diagnosis and clinical outcome.
  14. Expression of TGF-β1 in the blood during fracture repair in an estrogen-deficient rat model
    Estai MA, Suhaimi F, Das S, Shuid AN, Mohamed Z, Soelaiman IN
    Clinics (Sao Paulo), 2011;66(12):2113-9.
    PMID: 22189738
    OBJECTIVES: Previous studies have reported that osteoporosis due to estrogen deficiency influences fracture healing. Transforming growth factor (TGF-b) has been found to be involved in fracture healing via the regulation of the differentiation and activation of osteoblasts and osteoclasts. The current study aimed to determine the effects of estrogen on the expression of TGF-β1 during fracture healing in ovariectomized rats.

    METHODS: Thirty female Sprague-Dawley rats weighing 200-250 g were assigned to: (i) a sham-operated group that was given a normal saline; (ii) an ovariectomized control group that was given a normal saline; or (iii) an ovariectomized + estrogen (100 mg/kg/day) group that was treated with conjugated equine estrogen. The right femur of all rats was fractured, and a Kirschner wire was inserted six weeks post-ovariectomy. Treatment with estrogen was given for another six weeks post-fracture. At the end of the study, blood samples were taken, and the right femur was harvested and subjected to biomechanical strength testing.

    RESULTS: The percentage change in the plasma TGF-β1 level before treatment was significantly lower in the ovariectomized control and estrogen groups when compared with the sham group (p<0.001). After six weeks of treatment, the percentage change in the plasma TGF-β1 level in the estrogen group was significantly higher compared with the level in the ovariectomized control group (p = 0.001). The mean ultimate force was significantly increased in the ovariectomized rats treated with estrogen when compared with the ovariectomized control group (p = 0.02).

    CONCLUSION: These data suggest that treatment with conjugated equine estrogen enhanced the strength of the healed bone in estrogen-deficient rats by most likely inducing the expression of TGF-β1.

  15. Epithelioid sarcoma and concurrent Volkman ischaemic contracture: a case report
    Suria-Hayati MP, Siti-Aishah MA, Eshagroni A, Jamari S, Abdolvahab F, Yazmin Y, et al.
    Clin Ter, 2012;163(3):215-7.
    PMID: 22964694
    Epithelioid sarcoma is a very infrequent soft tissue sarcoma involving predominantly distal extremities of adolescent and young adult. We hereby report a case of epithelioid sarcoma in a 34-year-old young adult who presented with 1-year history of a painful left upper limb associated subsequently with warm left forearm swelling and a Volkman contracture. He was treated as an inflamed soft tissue condition of the left upper limb. A computed tomography study showed presence of multiple hypodense lesions mainly in the flexor compartment of the left arm as well at the subcutaneous tissue, which measured 1 to 1.7 cm in diameter. Histological examination of the left upper limb mass showed nodular proliferation of epithelioid tumour cells and some with rhabdoid features surrounding a central zone of necrosis and was diagnosed as epithelioid sarcoma. Concurrent presence of epithelioid sarcoma and Volkman ischaemic contracture are rarely seen in clinical practice. The present case highlights the importance of the histology which can be confused with other types of sarcoma or chronic granuloma and even missed at times thereby causing diagnostic problems.
  16. Information needs of family members of critically ill patients in intensive care unit of a tertiary hospital
    Noor Siah AA, Ho SE, Jafaar MZ, Choy YC, Das S, Ismail SM, et al.
    Clin Ter, 2012;163(1):63-7.
    PMID: 22362236
    BACKGROUND AND AIMS. The experience in intensive care unit (ICU) has created an intense emotional situation both to patients and their family members. The aim of this study was to determine the family members information needs of critically ill patients in ICU.

    MATERIALS AND METHODS:
    A descriptive cross-sectional study was conducted on 200 family members of patients admitted in ICU. A face to face interview was conducted and a self-report questionnaire of the Critical Care Family Needs Inventory (CCFNI) was used.

    RESULTS:
    Findings reported CCFNI five sub-attributes that ranked from highest to lowest included: support (mean 39.13 ± 6.189); proximity (mean 27.17 ± 3.384); information (mean 24.25 ± 3.093); assurance (mean 22.67 ± 1.862) and comfort (mean 16.24 ± 2.776). There were no significant differences in needs between family members with different gender (p >0.05). However, there were significant differences in support needs between family members with admission to ICU with (t=-2.111; p <0.05). There were significant differences in assurance needs (F=3.542; p <0.05) and information needs (F=3.681; p <0.05) between family members with age. There were no significant differences in needs between family members with different education level (p >0.05) whereas assurance needs were significant differences with education level of (F=3.542; p <0.05).

    CONCLUSION:
    The results suggest that family members perceived support and proximity as the most crucial need. Comfort need was viewed as least important. Although this study was conducted in a tertiary hospital, the findings could still provide insight for nurses to improve the delivery of care to patients and family members.
  17. Fulltext Engineered silybin nanoparticles educe efficient control in experimental diabetes
    Das S, Roy P, Pal R, Auddy RG, Chakraborti AS, Mukherjee A
    PLoS One, 2014;9(7):e101818.
    PMID: 24991800 DOI: 10.1371/journal.pone.0101818
    Silybin, is one imminent therapeutic for drug induced hepatotoxicity, human prostate adenocarcinoma and other degenerative organ diseases. Recent evidences suggest that silybin influences gluconeogenesis pathways favorably and is beneficial in the treatment of type 1 and type 2 diabetes. The compound however is constrained due to solubility (0.4 mg/mL) and bioavailabilty limitations. Appropriate nanoparticle design for silybin in biocompatible polymers was thus proposed as a probable solution for therapeutic inadequacy. New surface engineered biopolymeric nanoparticles with high silybin encapsulation efficiency of 92.11% and zeta potential of +21 mV were designed. Both the pure compound and the nanoparticles were evaluated in vivo for the first time in experimental diabetic conditions. Animal health recovered substantially and the blood glucose levels came down to near normal values after 28 days treatment schedule with the engineered nanoparticles. Restoration from hyperglycemic damage condition was traced to serum insulin regeneration. Serum insulin recovered from the streptozotocin induced pancreatic damage levels of 0.17 ± 0.01 µg/lit to 0.57 ± 0.11 µg/lit after nanoparticle treatment. Significant reduction in glycated hemoglobin level, and restoration of liver glycogen content were some of the other interesting observations. Engineered silybin nanoparticle assisted recovery in diabetic conditions was reasoned due to improved silybin dissolution, passive transport in nanoscale, and restoration of antioxidant status.
  18. Nasal type NK/T-cell lymphoma - diagnosis and treatment difficulties
    Hamidah NH, Shahrom S, Siti Aishah MA, Das S, Gendeh BS, Fadilah SA
    Clin Ter, 2014;165(3):139-42.
    PMID: 24999566 DOI: 10.7417/CT.2014.1711
    Primary nasal lymphomas are rare. One of the most common cellular subtypes in the Asian population is natural killer (NK)/T-cell lymphoma (NKTL) with a high association of EBV. We report a case of a 42-year-old female, who presented with a worsening sore throat, odynophagia, dysphagia to solid food due to oropharyngeal ulcers and bilateral nasal blockage and recurrent fever for the past two weeks prior to admission. Physical examination revealed ulcers over the soft palate with nasopharyngeal slough. Computerized Tomography (CT) scan of the neck showed nasopharyngeal abscess with bilateral maxillary ethnoidal sinusitis. The diagnostic and management challenge is discussed.
  19. Multifaceted profile of an unusual paramedian occipital condyle-anatomical and computerised tomographic evaluation
    Arora J, Mehta V, Abhishek K, Nisha S, Suri RK, Rath G, et al.
    Clin Ter, 2014;165(2):111-4.
    PMID: 24770815 DOI: 10.7471/CT.2014.1687
    During extensive osteological study of 150 dry skulls in the Department of Anatomy, Vardhman Mahavir Medical college, an unusual Paramedian Occipital (POC) condyle was detected in the occipital bone of a cadaveric skull. The anatomical details of this unusual occipital condyle were carefully studied and its morphometric measurements taken. A coronal multiplanner reformatted image and a volume rendered image were taken to study radiological details and establish significant clinical correlation. Precise understanding of anatomy of craniovertebral junction and its anomalies have become immensely important for the present day surgeon during orthopaedic and neurosurgical procedures of this region . Technical advancements in imaging modalities such as CT and MRI scans further signify the importance of these anatomical variations ,which are often missed in routine examination. Osteological study combined with radiological details of the paramedian occipital condyle in the present case aims to emphasize the importance of bony anomalies in the craniovertebral region and their role in diagnosis and appropriate treatment of neurovascular compression syndromes of craniovertebral junction. The present study highlights anatomical details, clinical relevance and embryological basis of such a rare unusual paramedian occipital condyle.
  20. Lambda light chain myeloma with co-migrating paraprotein at beta region on agarose gel electrophoresis: a case report
    Siti Sarah M, Nor Aini U, Nurismah MI, Hafiza A, Khalidah M, Mokhtar AB, et al.
    Clin Ter, 2014;165(1):35-9.
    PMID: 24589949 DOI: 10.7471/CT.2014.1659
    Paraproteinemia is one of the diagnostic features of multiple myeloma. A commonly used method is the detection of paraprotein by agarose gel electrophoresis (AGE) followed by by immunofixation electrophoresis (IFE) to confirm monoclonality. Due to their smaller size, immunoglobulin A (IgA) and light chain only paraproteins may appear at the beta or even alpha 2 protein fractions. Here, we discuss a case report of a 47-year-old man who presented with pathological fracture of third thoracic (T3) vertebra. Serum protein electrophoresis (SPE) was initially reported as no paraprotein detected. However, a bone biopsy was reported to show plasma cell proliferation with light chain restriction. A repeat sample for protein electrophoresis together with IFE revealed lambda light chain paraprotein co-migrating at the beta region. The beta band plus paraprotein was quantitated as 4.3 g/L (7.0%), which was within normal limits of the beta protein fraction. Hence, it has to be remembered that if the SPE is negative, it does not necessarily mean that the paraprotein is absent in cases which are highly suspicious.
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