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  1. Sidhu JK, Wan Hitam WH, Ahmad Tajudin LS
    Cureus, 2023 Feb;15(2):e35199.
    PMID: 36968851 DOI: 10.7759/cureus.35199
    The coronavirus disease 2019 (COVID-19) pandemic has led to the widespread use of steroids as a life-saving measure. In patients with preexisting diabetes, the therapeutic use of steroids coupled with poorly controlled sugar has led to a surge of mucormycosis. We report a rare case of orbital apex syndrome secondary to mucormycosis post-COVID-19. A 43-year-old female with poorly controlled diabetes mellitus presented with right eye complete ptosis one week post-recovery from COVID-19 infection. During COVID-19 hospitalization, she received a course of dexamethasone. The visual acuity of the right eye was 6/60. She had complete ophthalmoplegia and diplopia in all gazes. There was a positive relative afferent pupillary defect (RAPD) and reduced optic nerve function test in the right eye. MRI showed right ethmoid sinusitis with possible extension to the right orbit and the presence of right perineural optic nerve enhancement. The nasal scope revealed fungal-like thick mucopurulent discharge at the middle meatus. She was clinically diagnosed with rhino-orbital mucormycosis and was started on antifungal for six weeks. Her overall condition improved with 6/6 visual acuity and minimum residual ophthalmoplegia. In conclusion, corticosteroid treatment for COVID-19 infection in diabetic patients causes poor glycemic control and immunosuppression that can lead to secondary infections such as rhino-orbital mucormycosis.
  2. Ab Lloh S, Mohamad N, Badrin S, Abu Bakar R, Ahmad I
    J Ethn Subst Abuse, 2023;22(1):45-59.
    PMID: 33472556 DOI: 10.1080/15332640.2021.1871696
    The study aimed to determine the prevalence of continuity of illicit drug use and its associated factors among Malay opioid users receiving methadone treatment in Kelantan, Malaysia. This cross-sectional study involved a total of 150 respondents. Sociodemographic characteristic of participants, level of religiosity, and quality of life were collected using the self-administered questionnaires. The prevalence of continuity illicit drug use was 38.7% (n = 58) by self-report and 40.7% (n = 61) by positive urine test result for drugs. Positive hepatitis C status and high quality of life in the psychological health domain were associated with low continuity of illicit drug use by self-reported data and urine drug test results. In conclusion, the continuity of illicit drug use among methadone program users is still high, especially among those on methadone therapy for less than 2 years.
  3. Chen A, Azriff Basri A, Ismail NB, Arifin Ahmad K
    Bioengineering (Basel), 2023 Mar 01;10(3).
    PMID: 36978704 DOI: 10.3390/bioengineering10030312
    Subaortic stenosis (SAS) is a common congenital heart disease that can cause significant morbidity and mortality if not treated promptly. Patients with heart valve disease are prone to complications after replacement surgery, and the existence of SAS can accelerates disease progression, so timely diagnosis and treatment are required. However, the effects of subaortic stenosis on mechanical heart valves (MHV) are unknown. This study aimed to investigate flow characteristics in the presence of subaortic stenosis and computationally quantify the effects on the hemodynamics of MHV. Through the numerical simulation method, the flow characteristics and related parameters in the presence of SAS can be more intuitively observed. Based on its structure, there are three types of SAS: Tunnel-type SAS (TSS); Fibromuscular annulus SAS (FSS); Discrete SAS (DSS). The first numerical simulation study on different types of SAS found that there are obvious differences among them. Among them, the tunnel-type SAS formed a separated vortex structure on the tunnel-type narrow surface, which exhibits higher wall shear force at a low obstacle percentage. However, discrete SAS showed obvious differences when there was a high percentage of obstacles, forming high peak flow, high wall shear stress, and a high-intensity complex vortex. The presence of all three types of SAS results in the formation of high-velocity jets and complex vortices in front of the MHV, leading to increased shear stress and stagnation time. These hemodynamic changes significantly increase the risk of MHV dysfunction and the development of complications. Despite differences between the three types of SAS, the resultant effects on MHV hemodynamics are consistent. Therefore, early surgical intervention is warranted in SAS patients with implanted MHV.
  4. Rad MA, Tijjani AS, Ahmad MR, Auwal SM
    Sensors (Basel), 2016 Dec 23;17(1).
    PMID: 28025571 DOI: 10.3390/s17010014
    This paper proposes a new technique for real-time single cell stiffness measurement using lead zirconate titanate (PZT)-integrated buckling nanoneedles. The PZT and the buckling part of the nanoneedle have been modelled and validated using the ABAQUS software. The two parts are integrated together to function as a single unit. After calibration, the stiffness, Young's modulus, Poisson's ratio and sensitivity of the PZT-integrated buckling nanoneedle have been determined to be 0.7100 N·m-1, 123.4700 GPa, 0.3000 and 0.0693 V·m·N-1, respectively. Three Saccharomyces cerevisiae cells have been modelled and validated based on compression tests. The average global stiffness and Young's modulus of the cells are determined to be 10.8867 ± 0.0094 N·m-1 and 110.7033 ± 0.0081 MPa, respectively. The nanoneedle and the cell have been assembled to measure the local stiffness of the single Saccharomyces cerevisiae cells The local stiffness, Young's modulus and PZT output voltage of the three different size Saccharomyces cerevisiae have been determined at different environmental conditions. We investigated that, at low temperature the stiffness value is low to adapt to the change in the environmental condition. As a result, Saccharomyces cerevisiae becomes vulnerable to viral and bacterial attacks. Therefore, the proposed technique will serve as a quick and accurate process to diagnose diseases at early stage in a cell for effective treatment.
  5. Utami M, Setiawati F, Ahmad MS, Adiatman M
    Int J Paediatr Dent, 2023 May;33(3):259-268.
    PMID: 36336994 DOI: 10.1111/ipd.13036
    BACKGROUND: Maintenance of oral health of children with special needs requires the involvement of caregivers who are also responsible for ensuring adherence to professional recommendations, including dental visits.

    AIM: This study aimed at exploring the correlates of dental visits of children with hearing loss (CWHL) in Indonesia using the theory of planned behaviour (TPB).

    DESIGN: This cross-sectional study involved purposive sampling methods, conducted via an online survey administered to mothers of CWHL who were aged 5-12 years. Constructs of the TPB model were collected, including the mother's attitudes, subjective norms, perceived behaviour control (PBC) and intention towards dental visits for CWHL. Dental visits were measured by asking whether their children had a dental visit within the last 12 months. Data were analysed using SPSS for descriptive and bivariate analyses. The significance level was set as p  .05). Intention did not significantly predict the mother's behaviour towards children's dental visits (p > .05).

    CONCLUSION: The TPB model revealed a construct associated with dental visit intention and behaviour in CWHL. This study suggested that effective promotion intervention should focus on the mother's PBC to increase parents' adherence to preventive dental visits in CWHL in Indonesia.

  6. Azhar NA, Abu Bakar SA, Citartan M, Ahmad NH
    World J Hepatol, 2023 Mar 27;15(3):393-409.
    PMID: 37034237 DOI: 10.4254/wjh.v15.i3.393
    BACKGROUND: The demand for the development of cancer nanomedicine has increased due to its great therapeutic value that can overcome the limitations of conventional cancer therapy. However, the presence of various bioactive compounds in crude plant extracts used for the synthesis of silver nanoparticles (AgNPs) makes its precise mechanisms of action unclear.

    AIM: To assessed the mRNA transcriptome profiling of human HepG2 cells exposed to Catharanthus roseus G. Don (C. roseus)-AgNPs.

    METHODS: The proliferative activity of hepatocellular carcinoma (HepG2) and normal human liver (THLE3) cells treated with C. roseusAgNPs were measured using MTT assay. The RNA samples were extracted and sequenced using BGIseq500 platform. This is followed by data filtering, mapping, gene expression analysis, differentially expression genes analysis, Gene Ontology analysis, and pathway analysis.

    RESULTS: The mean IC50 values of C. roseusAgNPs on HepG2 was 4.38 ± 1.59 μg/mL while on THLE3 cells was 800 ± 1.55 μg/mL. Transcriptome profiling revealed an alteration of 296 genes. C. roseusAgNPs induced the expression of stress-associated genes such as MT, HSP and HMOX-1. Cellular signalling pathways were potentially activated through MAPK, TNF and TGF pathways that are responsible for apoptosis and cell cycle arrest. The alteration of ARF6, EHD2, FGFR3, RhoA, EEA1, VPS28, VPS25, and TSG101 indicated the uptake of C. roseus-AgNPs via both clathrin-dependent and clathrin-independent endocytosis.

    CONCLUSION: This study provides new insights into gene expression study of biosynthesised AgNPs on cancer cells. The cytotoxicity effect is mediated by the aberrant gene alteration, and more interestingly the unique selective antiproliferative properties indicate the C. roseusAgNPs as an ideal anticancer candidate.

  7. Balakrishnan SG, Ahmad MR, Koloor SSR, Petrů M
    J Adv Res, 2021 Nov;33:109-116.
    PMID: 34603782 DOI: 10.1016/j.jare.2021.03.001
    INTRODUCTION: Conventional biopsy, based on extraction from a tumor of a solid tissue specimen requiring needles, endoscopic devices, excision or surgery, is at risk of infection, internal bleeding or prolonged recovery. A non-invasive liquid biopsy is one of the greatest axiomatic consequences of the identification of circulating tumor DNA (ctDNA) as a replaceable surgical tumor bioQpsy technique. Most of the literature studies thus far presented ctDNA detection at almost final stage III or IV of cancer, where the treatment option or cancer management is nearly impossible for diagnosis.

    OBJECTIVE: Hence, this paper aims to present a simulation study of extraction and separation of ctDNA from the blood plasma of cancer patients of stage I and II by superparamagnetic (SPM) bead particles in a microfluidic platform for early and effective cancer detection.

    METHOD: The extraction of ctDNA is based on microfiltration of particle size to filter some impurities and thrombocytes plasma, while the separation of ctDNA is based on magnetic manipulation to high yield that can be used for the upstream process.

    RESULT: Based on the simulation results, an average of 5.7 ng of ctDNA was separated efficiently for every 10 µL blood plasma input and this can be used for early analysis of cancer management. The particle tracing module from COMSOL Multiphysics traced ctDNA with 65.57% of sensitivity and 95.38% of specificity.

    CONCLUSION: The findings demonstrate the ease of use and versatility of a microfluidics platform and SPM bead particles in clinical research related to the preparation of biological samples. As a sample preparation stage for early analysis and cancer diagnosis, the extraction and separation of ctDNA is most important, so precision medicine can be administered.

  8. Aizat WM, Ahmad-Hashim FH, Syed Jaafar SN
    J Adv Res, 2019 Nov;20:61-70.
    PMID: 31210985 DOI: 10.1016/j.jare.2019.05.005
    One of the most prolific plants utilized in various applications is mangosteen (Garcinia mangostana L.). Rich in potent bioactive compounds, such as xanthones, mangosteen is known to possess pharmacologically important anti-inflammatory and anti-tumor properties. However, most previous reviews have only discussed the application of mangosteen in medicinal areas, yet more recent studies have diverged and valorized its usage in other scientific fields. In this review, the utilization of this exotic fruit in postharvest biology (phytohormone roles, metabolite profiling, bioactive compounds, isolation method optimization, chemical contaminant identification, and management of pests and fruit disorders), food science (food products, animal feed supplementation, and food shelf-life determination), and engineering fields (fabric and solar cell dyes, carbon dots, activated carbon, and biomedical advanced materials) is presented in detail. Research papers published from 2016 onward were selected and reviewed to show the recent research trends in these areas. In conclusion, mangosteen has been utilized for various purposes, ranging from usage in industrially important products to applications in advanced technologies and biomedical innovation.
  9. Oslan SNH, Yusof NY, Lim SJ, Ahmad NH
    J Microbiol Methods, 2024 Apr;219:106897.
    PMID: 38342249 DOI: 10.1016/j.mimet.2024.106897
    Salmonella is as an intracellular bacterium, causing many human fatalities when the host-specific serotypes reach the host gastrointestinal tract. Nontyphoidal Salmonella are responsible for numerous foodborne outbreaks and product recalls worldwide whereas typhoidal Salmonella are responsible for Typhoid fever cases in developing countries. Yet, Salmonella-related foodborne disease outbreaks through its food and water contaminations have urged the advancement of rapid and sensitive Salmonella-detecting methods for public health protection. While conventional detection methods are time-consuming and ineffective for monitoring foodstuffs with short shelf lives, advances in microbiology, molecular biology and biosensor methods have hastened the detection. Here, the review discusses Salmonella pathogenic mechanisms and its detection technology advancements (fundamental concepts, features, implementations, efficiency, benefits, limitations and prospects). The time-efficiency of each rapid test method is discussed in relation to their limit of detections (LODs) and time required from sample enrichment to final data analysis. Importantly, the matrix effects (LODs and sample enrichments) were compared within the methods to potentially speculate Salmonella detection from environmental, clinical or food matrices using certain techniques. Although biotechnological advancements have led to various time-efficient Salmonella-detecting techniques, one should consider the usage of sophisticated equipment to run the analysis by moderately to highly trained personnel. Ultimately, a fast, accurate Salmonella screening that is readily executed by untrained personnels from various matrices, is desired for public health procurement.
  10. Abdullah F, Jaafar MH, Ahmad MI, Ismail ZS
    Int J Environ Health Res, 2024 May;34(5):2280-2298.
    PMID: 37552824 DOI: 10.1080/09603123.2023.2243843
    In Malaysia, chemical management in workplaces is managed under the Occupational Safety and Health Act 1994. Hence, the introduction of the Occupational Safety and Health (Use and Standards of Exposure of Chemicals Hazardous to Health) Regulations 2000 has strengthened the chemical management level in workplaces, including higher academic institutions. The introduction of chemical health risk assessment through the regulation required management to conduct the assessment at workplaces. Poor levels of Indoor Air Quality (IAQ) in chemical laboratories may also cause discomfort among workers when there is sick building syndrome in laboratories. IAQ is managed through the Industry Code of Practice on Indoor Air Quality 2010. Although both are different in method and approach, both are meant to ensure the workers' safety and comfort. This study is aimed to investigate the need to integrate both chemical health risk assessment and IAQ assessment in laboratories to ensure optimum safety levels among workers.
  11. Mansor MA, Ahmad MR, Petrů M, Rahimian Koloor SS
    Artif Cells Nanomed Biotechnol, 2023 Dec;51(1):371-383.
    PMID: 37548425 DOI: 10.1080/21691401.2023.2239274
    Electrical characteristics of living cells have been proven to reveal important details about their internal structure, charge distribution and composition changes in the cell membrane, as well as the extracellular context. An impedance flow cytometry is a common approach to determine the electrical properties of a cell, having the advantage of label-free and high throughput. However, the current techniques are complex and costly for the fabrication process. For that reason, we introduce an integrated dual microneedle-microchannel for single-cell detection and electrical properties extraction. The dual microneedles utilized a commercially available tungsten needle coated with parylene. When a single cell flows through the parallel-facing electrode configuration of the dual microneedle, the electrical impedance at multiple frequencies is measured. The impedance measurement demonstrated the differential of normal red blood cells (RBCs) with three different sizes of microbeads at low and high frequencies, 100 kHz and 2 MHz, respectively. An electrical equivalent circuit model (ECM) was used to determine the unique membrane capacitance of individual cells. The proposed technique demonstrated that the specific membrane capacitance of an RBC is 9.42 mF/m-2, with the regression coefficients, ρ at 0.9895. As a result, this device may potentially be used in developing countries for low-cost single-cell screening and detection.
  12. Mat Jalaluddin NS, Ahmad Fuaad AA, Othman RY
    Transgenic Res, 2024 Apr 10.
    PMID: 38600337 DOI: 10.1007/s11248-024-00379-9
    Banana is a premier fruit crop in many parts of the world especially Southeast Asia. The demand for banana has contributed to significant national income to primary banana producers in the SEA region such as the Philippines, Indonesia, Thailand, Vietnam, and Malaysia. However, the widely traded banana industry is plagued by numerous threats including pests and diseases, post-harvest issues and extreme climate vulnerability. To address these challenges, new breeding techniques such as gene editing have been explored for breeding programs to develop improved banana varieties. The first gene-edited non-browning banana has been deregulated in the Philippines recently, and more regulatory applications are expected to submit for approvals soon. Hence, it is timely to review the policy options for gene editing that have been adopted and discussed in the Southeast Asian countries and highlight the implications of differing regulatory approaches to gene editing for trading activities. Positive stakeholders' perceptions and public acceptance are key factors in allowing the benefits of gene editing and thus appropriate outreach strategies are important to gain acceptance and avoid the "GMO stigma" that may be associated with gene-edited products.
  13. Low TH, Faruk Senan NA, Ahmad TS
    J Hand Surg Am, 2012 May;37(5):930-2.
    PMID: 22386556 DOI: 10.1016/j.jhsa.2012.01.020
    To obtain epidemiologic data on the Linburg-Comstock anomaly in Malaysia and to study the effect of the anomaly on key pinch strength.
  14. Nasharudin MIH, Siew SW, Ahmad HF, Mahmud N
    Mol Biol Rep, 2024 Apr 11;51(1):503.
    PMID: 38600404 DOI: 10.1007/s11033-024-09492-8
    BACKGROUND: Komagataeibacter nataicola (K. nataicola) is a gram-negative acetic acid bacterium that produces natural bacterial cellulose (BC) as a fermentation product under acidic conditions. The goal of this work was to study the complete genome of K. nataicola and gain insight into the functional genes in K. nataicola that are responsible for BC synthesis in acidic environments.

    METHODS AND RESULT: The pure culture of K. nataicola was obtained from yeast-glucose-calcium carbonate (YGC) agar, followed by genomic DNA extraction, and subjected to whole genome sequencing on a Nanopore flongle flow cell. The genome of K. nataicola consists of a 3,767,936 bp chromosome with six contigs and 4,557 protein coding sequences. The maximum likelihood phylogenetic tree and average nucleotide identity analysis confirmed that the bacterial isolate was K. nataicola. The gene annotation via RAST server discovered the presence of cellulose synthase, along with three genes associated with lactate utilization and eight genes involved in lactate fermentation that could potentially contribute to the increase in acid concentration during BC synthesis.

    CONCLUSION: A more comprehensive genome study of K. nataicola may shed light into biological pathway in BC productivity as well as benefit the analysis of metabolites generated and understanding of biological and chemical interactions in BC production later.

  15. Khan AJ, Ahmad MS, Sabri BAM
    Spec Care Dentist, 2024;44(3):659-675.
    PMID: 37964052 DOI: 10.1111/scd.12940
    INTRODUCTION: Individuals with visual impairment (VI) are doubly disadvantaged by their lack of vision and poor oral hygiene (OH). Implementing oral health education (OHE) interventions should be set as goals to improve OH status and prevent oral diseases. However, few studies have examined the specific teaching method of OH skills. This study aimed to identify the most influential OHE interventions enabling individuals with VI worldwide, especially those in countries where VI is most frequent, to maintain OH and improve knowledge and practices.

    METHODS: An extensive literature review was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis method. This study systematically searched electronic databases (PubMed via Medline, Cochrane, Embase, and Google Scholar) using expert-validated keywords, complemented by manual searches, to identify relevant articles published between April 1, 2012, and September 30, 2022.

    RESULT: PICOS criteria were formulated for study inclusion. The bibliographical search identified 1485 articles, which were subsequently filtered. Two researchers separately screened the articles for eligibility and to reduce the risk of bias in the included studies. Finally, the most pertinent 21 articles were scrutinized for data synthesis.

    CONCLUSION: Most studies identified combination methods, including customized educational demonstrations, as the best at improving OH status, knowledge, and practices. However, long-term, rigorously designed, and effective patient-centered communication trials, including those on innovative methods, are still needed for individuals with VI.

  16. Mawazi SM, Kumar M, Ahmad N, Ge Y, Mahmood S
    Polymers (Basel), 2024 May 10;16(10).
    PMID: 38794545 DOI: 10.3390/polym16101351
    Chitosan, a versatile biopolymer derived from chitin, has garnered significant attention in various biomedical applications due to its unique properties, such as biocompatibility, biodegradability, and mucoadhesiveness. This review provides an overview of the diverse applications of chitosan and its derivatives in the antibacterial, anticancer, wound healing, and tissue engineering fields. In antibacterial applications, chitosan exhibits potent antimicrobial properties by disrupting microbial membranes and DNA, making it a promising natural preservative and agent against bacterial infections. Its role in cancer therapy involves the development of chitosan-based nanocarriers for targeted drug delivery, enhancing therapeutic efficacy while minimising side effects. Chitosan also plays a crucial role in wound healing by promoting cell proliferation, angiogenesis, and regulating inflammatory responses. Additionally, chitosan serves as a multifunctional scaffold in tissue engineering, facilitating the regeneration of diverse tissues such as cartilage, bone, and neural tissue by promoting cell adhesion and proliferation. The extensive range of applications for chitosan in pharmaceutical and biomedical sciences is not only highlighted by the comprehensive scope of this review, but it also establishes it as a fundamental component for forthcoming research in biomedicine.
  17. Yap WB, Ahmad FM, Lim YC, Zainalabidin S
    Korean J Physiol Pharmacol, 2016 Nov;20(6):621-628.
    PMID: 27847439
    Hypertension can be caused by various factors while the predominant causes include increase in body fluid volume and resistance in the circulatory system that elevate the blood pressure. Consumption of probiotics has been proven to attenuate hypertension; however, the effect is much strain-dependent. In this study, a newly isolated Lactobacillus casei (Lb. casei) strain C1 was investigated for its antihypertensive properties in spontaneously hypertensive rats (SHR). Lactic acid bacteria (LAB) suspension of 11 log colony-forming unit (CFU) was given to SHR (SHR+LAB, n=8), and phosphate buffer saline (PBS) was given as a control in SHR (SHR, n=8) and in Wistar rats as sham (WIS, n=8). The treatment was given via oral gavage for 8 weeks. The results showed that the weekly systolic blood pressure (SBP), mean arterial pressure (MAP), diastolic blood pressure (DBP) and aortic reactivity function were remarkably improved after 8 weeks of bacterial administration in SHR+LAB. These effects were mostly attributed by restoration of wall tension and tensile stress following the bacterial treatment. Although not statistically significant, the level of malondialdehye (MDA) in SHR+LAB serum was found declining. Increased levels of glutathione (GSH) and nitric oxide (NO) in SHR+LAB serum suggested that the bacterium exerted vascular protection through antioxidative functions and relatively high NO level that induced vasodilation. Collectively, Lb. casei strain C1 is a promising alternative for hypertension improvement.
  18. Chin AHB, Muhsin SM, Ahmad MF
    Asian Bioeth Rev, 2023 Jul;15(3):335-349.
    PMID: 37396675 DOI: 10.1007/s41649-022-00236-z
    Non-medical or Social egg freezing (oocyte cryopreservation) is currently a controversial topic in Islam, with contradictory fatwas being issued in different Muslim countries. While Islamic authorities in Egypt permit the procedure, fatwas issued in Malaysia have banned single Muslim women from freezing their unfertilized eggs (vitrified oocytes) to be used later in marriage. The underlying principles of the Malaysian fatwas are that (i) sperm and egg cells produced before marriage, should not be used during marriage to conceive a child; (ii) extraction of mature egg cells from single women being unacceptable; and (iii) fertility preservation in anticipation of late marriage is a conjecture that has not yet occurred. Ovarian tissue freezing can potentially be a more Shariah-compliant alternative to social egg freezing, because once the frozen ovarian cortical tissue sections have been re-transplanted back into the woman, mature egg cells can readily be produced, collected, and fertilized by the husband's sperm only during the period of marriage contract ('akd al-nikāḥ). Unlike accidental mix-ups with frozen eggs, muddling of lineage (nasab) would be automatically avoided in ovarian tissue freezing due to immunological rejection. However, upon critical analysis based on Qawā'id Fiqhiyyah (Islamic Legal Maxims), Maqāṣid-al-Shariah (Higher Objectives of Islamic Law), and Maslaḥah-Mafsadah (benefits versus harmful effects on society), elective ovarian tissue freezing by healthy single women for social reasons would likely be a highly contentious and controversial issue within Muslim communities that may conflict with conservative social-religious norms. This thus needs further debate among Islamic jurists in dialogue with medical doctors and biomedical scientists.
  19. Ahmad Y, Shahril NS, Hussein H, Said MS
    J Clin Med Res, 2010 Dec 11;2(6):284-8.
    PMID: 22043264 DOI: 10.4021/jocmr482w
    We would like to report a case of a 29-year-old male patient who presented with multiple lymphadenopathy and vague symptoms of low grade fever, cough, weight loss, rashes, vomiting, dry eyes and dry mouth. Physical examination revealed submandibular lymphadenopathy, vasculitic rashes over both lower limbs, and parotid gland enlargement. Blood investigations showed mild anemia with leukocytosis, predominantly eosinophilia and high erythrocyte sedimentation rate and C-reactive protein. Computed tomography of the neck, thorax and abdomen showed bilateral submandibular, submental adenopathy, mediastinal and para-aortic lymphadenopathy with generalized reticulonodular densities in both lower lobes. There were hepatomegaly and bilateral enlarged kidneys with renal cyst. Histopathological examination from the cervical lymph node later revealed non-caseating granuloma, consistent of sarcoidosis. Patient responded well to prednisolone 50 mg daily with subsequent reduction in the size of cervical lymphadenopathy and parotid swelling.

    KEYWORDS: Lymphadenopathy; Granuloma; Sjogren; Sarcoidosis.
  20. Ahmad A, Kamarulzaman A, Kazatchkine M, Dreifuss R, Clark H
    Lancet, 2024 May 11;403(10439):1851-1852.
    PMID: 38734469 DOI: 10.1016/S0140-6736(24)00763-3
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