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Fulltext A protocol on information-motivation-behavioural skills risk of intensive phase treatment interruption among pulmonary tuberculosis patients in urban districts, Selangor

Qudsiah Suliman, Salmiah Md. Said, Nor Afiah Mohd. Zulkefli, Lim Poh Ying, Tan Kit-Aun

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):85-93.
MyJurnal

Introduction: Despite advancement of treatment modalities, Tuberculosis (TB) treatment interruption rate has glob- ally accelerating, calling for greater framework shifting towards psychosocial intervention. Similarly, Selangor state had reported the perturbing TB treatment interruption rate, which was figured persistently above 10% in the interval year of 2014 to 2018, thus signifies an empirical assessment on Information-Motivation-Behavioural skills (IMB) determinants of TB intensive phase treatment. This study aims to determine the time to intensive phase TB treatment interruption and its prognostic factors among newly diagnosed pulmonary Tuberculosis (PTB) smear positive patients in urban district Selangor. Methods: A multi-centric prospective cohort study will recruit 695 newly diagnosed PTB smear positive patients at treatment centres in urban districts, Selangor. This study will utilize validated self-admin- istered questionnaire and standardised data collection form (PROFORMA). At baseline, we will elicit information on IMB models constructs, additionally on socio-demographics, health service factors and clinical characteristics. Meanwhile, four points follow up will be executed to retrieve information on treatment status and time varying effects of body weight, treatment side effects, symptoms improvement and internalised stigma. Finally, survival analysis will be computed to identify the time to intensive phase treatment interruption and its prognostic factors. Conclusion: This study will enlighten IMB model determinants of intensive phase treatment interruption, hence to endeavour psychosocial elements in designing time relevant public health strategies in TB case management.

Matched MeSH terms: Prognosis
Fulltext A rare presentation ofcCutaneous metastases in advanced lung adenocarcinoma

Liyana Dhamirah Aminuddin, Sabrina Ab Wahab, Suhaili Shariffudin, Tarita Tai

Journal of Clinical and Health Sciences, 2020;5(2):75-78.
MyJurnal

Patients with lung cancer may present with respiratory and systemic symptoms. However,
cutaneous metastases from primary lung cancer is a rare phenomenon, especially in women,
that signifies a poor prognosis. This paper reported a case regarding a 71-year-old woman
who was first presented with a cutaneous nodule over the year. Her condition was further
progressed to multiple lesions on the back and abdomen, dyspnoea, haemoptysis and weight
loss. The results of the skin lesion biopsy exhibited metastatic lung adenocarcinoma with
positive immunohistochemistry for thyroid transcription factor 1 (TTF1) and cytokeratin 7 (CK7). Computed tomography (CT) scan was conducted, and it revealed a left upper lobe lung
mass. The patient was subsequently scheduled for additional management, but she had
succumbed to complications of pulmonary embolism before the necessary interventions could
be provided. In this particular case presentation, the biopsy of cutaneous lesions obtained had
revealed an undiagnosed primary malignancy.

Matched MeSH terms: Prognosis
Fulltext Plasma and cell lysate proteins associated with treatment outcome in acute myeloid leukaemia

Fatemeh Barantalab, Pei-Pei Chong, Cindee Lee, Stephnie Kang Xian Yiau, Kian Meng Chang, Zainina Seman, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):23-29.
MyJurnal

Introduction: Drug-resistance is a major hindrance to successful treatment of AML. Current predictive biomarkers are mainly genetic aberrations and insufficient in foretelling treatment outcome in all acute myeloid leukaemia (AML) due to its heterogeneous and aggressive nature. Proteins are stable and reliable. Secreted proteins in AML may have predictive or prognostic values for early intervention. Proteomic studies on AML are few and further investigations will benefit in selection of best markers. The aim of the study was to identify differentially expressed plasma proteins in AML with different treatment outcome. Methods: Two-dimensional electrophoresis (2-DE) technique was utilised to identify proteins differentially expressed in chemo-sensitive/chemo-resistant AML. Plasma and peripheral blood mononuclear cell (PBMC) lysate proteome analysis were performed on six chemo-resistant, four chemo-sensitive and six healthy controls and seven chemo-resistant, three chemo-sensitive and six healthy controls, respectively. Each experiment was conducted in duplicate or triplicate. Images were captured and protein spots detected by software. Differentially expressed protein spots were excised from gel and proteins were identified using LC/MS/MS. Proteins spots that were also detected in healthy controls were excluded. Results: Comparing mean % volume of each spot demonstrated significantly enhanced expression of apoliprotein-E (APO-E) and haptoglobin (HP) (p

Matched MeSH terms: Prognosis
Effect of Intracanal Medicaments on the Bond Strength of Bioceramic Root Filling Materials to Oval Canals

Al-Haddad AY, Kacharaju KR, Haw LY, Yee TC, Rajantheran K, Mun CS, et al.

J Contemp Dent Pract, 2020 Nov 01;21(11):1218-1221.
PMID: 33850066

AIM: This study aimed to evaluate the effect of the prior application of intracanal medicaments on the bond strength of OrthoMTA (mineral trioxide aggregate) and iRoot SP to the root dentin.
MATERIALS AND METHODS: Thirty single-rooted mandibular premolars were standardized and prepared using ProTaper rotary files. The specimens were divided into a control group and two experimental groups receiving Diapex and Odontopaste medicament, either filled with iRoot SP or OrthoMTA, for 1 week. Each root was sectioned transversally, and the push-out bond strength and failure modes were evaluated. The data were analyzed using Kruskal Wallis and Mann-Whitney U post hoc test.
RESULTS: There was no significant difference between the bond strength of iRoot SP and OrthoMTA without medicaments and with the prior placement of Diapex (p value > 0.05). However, iRoot SP showed significantly higher bond strength with the prior placement of Odontopaste (p value < 0.05). Also, there was no association between bond strength of OrthoMTA with or without intracanal medicament (p value > 0.05) and between failure mode and root filling materials (p value > 0.05). The prominent failure mode for all groups was cohesive.
CONCLUSION: Prior application of Diapex has no effect on the bond strength of iRoot SP and OrthoMTA. However, Odontopaste improved the bond strength of iRoot SP.
CLINICAL SIGNIFICANCE: Dislodgment resistance of root canal filling from root dentin could be an indicator of the durability and prognosis of endodontic treated teeth.

Matched MeSH terms: Prognosis
Fulltext Vast opportunity to study microrna (miRNA) in head and neck cancer among Malaysian population

Mohd. Arifin Kaderi, Kahairi Abdullah, Wan Ishlah Leman, Azmir Ahmad

International Journal of Allied Health Sciences, 2018;2(3):475-488.
MyJurnal

Head and neck cancer (HNC) is among the common cancer in Malaysia. Depending on the location of the cancer in head and neck region, each type of HNC has its own characteristics and prevalence to specific gender and ethnicity. The remote and inaccessible location of the cancer also cause the difficulty to detect the cancer. This make the cancer usually diagnosed at late stage and make the treatment very challenges and ended with low survival rate of post-treatment among HNC patients. In fact, the detection of HNC at early stage could promise high successful recovery rate. This situation demand lots of studies to explore the carcinogenesis of HNC and searching for robust diagnostic, prognostic and therapeutic biomarkers. MicroRNA (miRNA) is a class of non-coding RNA that regulate cellular physiology at post-transcriptional level. miRNAs expression has
been found to deregulate in various disease state, including cancer. A few studies revealed that miRNAs can behave as oncogenic and tumour suppressor in HNC. Even HNC is common in Malaysia, the studies of miRNA in HNC are still scarce. In this review article, we highlight the studies of miRNA in HNC that have been published by Malaysian researchers with aim to call more Malaysian researchers to focus on miRNA researches in HNC.

Matched MeSH terms: Prognosis
Fulltext miRNAS as potential biomarkers in head and neck squamous cell carcinoma diagnostics

Cheah Yoke Kqueen, Yaghma Masood, Nurul Syakima Ab Mutalib, Sethu Thakachy Subha, Norhafizah Mohtarrudin

Malaysian Journal of Medicine and Health Sciences, 2019;15(108):9-9.
MyJurnal

MicroRNAs (miRNAs) are small noncoding RNAs that involved in various normal and cancer-related cellular pro-cesses. Studies on expression profiling of miRNAs have been performed and the data showed that some miRNAs are up-regulated or down-regulated in cancer. miRNAs play a crucial role in HNSCC development, metastasis, prognosis and survival rate. Several studies have been conducted previously to investigate that use of miRNAs as the biomark-ers in disease diagnostic/prognostic and potential therapeutic targets management that may improve the outcomes of HNSCC. Our previous study revealed that upregulation of oncogenic miRNAs including hsa-miR-181a-2*, hsa-miR-29b-1*, hsa-miR-181a, hsa-miR-181b, hsa-miR-744, hsa-miR-1271 and hsa-miR-221* were able to distinguish HNSCC from normal samples. These miRNAs may contribute in a simple profiling strategy to identify individuals at higher risk of developing head and neck cancers, thus helping in the elucidation of the molecular mechanisms involved in head and neck cancer pathogenesis.

Matched MeSH terms: Prognosis
Fulltext Programmed cell death-ligand, thymidylate synthase and deleted in colorectal carcinoma biomarkers in colorectal carcinoma

Fauzah Abd Ghani, Reena Rehavu Zin, Maha Abdullah, Norhafizah Mohtarrudin, Ebenyi Emeka Onwe

Malaysian Journal of Medicine and Health Sciences, 2019;15(108):16-16.
MyJurnal

Introduction: It is well known that cancer cells evade the immune system with the help of programmed cell death protein 1 (PD-L1) molecule to remain undetected, causing abnormal proliferation of T-cells. PD-L1 expression on the surface of neoplastic cells inhibits cytotoxic T-cell responses which lead to negative regulation of cytokines and proliferation of T-cells. The deleted in colorectal cancer (DCC) gene belongs to the immunoglobulin superfamily. It is a candidate of the tumour suppressor gene by regulating apoptosis. DCC assessment gives an insight into progno-sis in patients with advanced stages of CRC. Thymidylate synthase (TYMS) is a highly conserved enzyme involved in DNA synthesis. TYMS has been an important target for cancer chemotherapy because of its central, rate-limiting role in de novo synthesis of thymidylate. Expression of PD-L1, TYMS and DCC has been demonstrated to confer a prognostic value in CRC but none have been completely validated for patient care. This study aimed to determine the prognostic and predictive potential of PD-L1, TYMS, and DCC biomarkers in CRC. Methods: The expression of these biomarkers was evaluated immunohistochemically in 91 formalin-fixed paraffin-embedded (FFPE) archival tumour samples from patients that underwent surgical resection. Results: There was high expression of DCC in most cases; 84.6% (77/91). TYMS expression at a high level score was 46.2% (42/91) and at low level was 53.8% (49/91). Majority of cases had low PD-L1 expression in 93.4% (86/91) cases and high expression was detected in 6.6% (6/94) of cases. In addition, there was a significant association between TYMS expression with gender (P < 0.05) with distribution of TYMS expression detected at high level was 76.2% in male and 23.8% in female. The Kaplan-Meier survival plot showed mean overall survival in patients with PD-L1 with high expression to be 22 months, which pre-dicts better survival. TYMS low expression showed mean overall survival of 90 which also indicated better survival. DCC high expression showed mean overall survival of 90 which indicated better survival. The correlation between the biomarkers and overall survival were not statistically significant. Conclusion: The results from this study suggest that PD-L1, TYMS and DCC expression could be used as biomarkers to predict treatment outcome in CRC. PD-L1 overexpression predicts patients who could benefit from anti-PD-1 and anti-PD-L1 immunotherapy whilst TYMS low expression predicts patients who could benefit from 5-fluorouracil therapy. DCC high expression tumours predicts a better prognosis and overall survival compared to DCC-negative tumours in advanced CRC.

Matched MeSH terms: Prognosis
Fulltext The Role of Breast Cancer Stem Cell-Related Biomarkers as Prognostic Factors

Ko CCH, Chia WK, Selvarajah GT, Cheah YK, Wong YP, Tan GC

Diagnostics (Basel), 2020 Sep 19;10(9).
PMID: 32961774 DOI: 10.3390/diagnostics10090721

Breast cancer is one of the leading causes of cancer-related deaths in women worldwide, and its incidence is on the rise. A small fraction of cancer stem cells was identified within the tumour bulk, which are regarded as cancer-initiating cells, possess self-renewal and propagation potential, and a key driver for tumour heterogeneity and disease progression. Cancer heterogeneity reduces the overall efficacy of chemotherapy and contributes to treatment failure and relapse. The cell-surface and subcellular biomarkers related to breast cancer stem cell (BCSC) phenotypes are increasingly being recognised. These biomarkers are useful for the isolation of BCSCs and can serve as potential therapeutic targets and prognostic tools to monitor treatment responses. Recently, the role of noncoding microRNAs (miRNAs) has extensively been explored as novel biomarker molecules for breast cancer diagnosis and prognosis with high specificity and sensitivity. An in-depth understanding of the biological roles of miRNA in breast carcinogenesis provides insights into the pathways of cancer development and its utility for disease prognostication. This review gives an overview of stem cells, highlights the biomarkers expressed in BCSCs and describes their potential role as prognostic indicators.

Matched MeSH terms: Prognosis
Stroke and Novel Coronavirus Infection in Humans: A Systematic Review and Meta-Analysis

Lee KW, Yusof Khan AHK, Ching SM, Chia PK, Loh WC, Abdul Rashid AM, et al.

Front Neurol, 2020;11:579070.
PMID: 33123082 DOI: 10.3389/fneur.2020.579070

Background: As the world witnessed the devastation caused by the coronavirus disease 2019 (COVID-19) outbreak, a growing body of literature on COVID-19 is also becoming increasingly available. Stroke has increasingly been reported as a complication of COVID-19 infection. However, a systematic synthesis of the available data has not been conducted. Therefore, we performed a systematic review and meta-analysis of currently available epidemiological, clinical, and laboratory data related to both stroke and COVID-19 infection. Methods: We systematically searched Medline, Cinahl, and PubMed for studies related to stroke and COVID-19 from inception up to June 4, 2020. We selected cohort studies, case series, and case reports that reported the occurrence of stroke in COVID-19 patients. A fixed-effects model was used to estimate the pooled frequency of stroke in COVID-19 patients with a 95% confidence interval (CI). Results: Twenty-eight studies were included in the systematic review and seven studies for the meta-analysis. The pooled frequency of stroke in COVID-19 patients was 1.1% (95% CI: 0.8, 1.3). The heterogeneity was low (I2 = 0.0%). Even though the frequency of stroke among patients having COVID-19 infection was low, those with concomitant COVID-19 infection and stroke suffered from a more severe infection and eventually had a poorer prognosis with a higher mortality rate (46.7%) than COVID-19 alone. Many COVID-19 patients shared the common traditional risk factors for stroke. We noted that ischemic stroke involving the anterior circulation with large vessels occlusion is the most common type of stroke with more strokes seen in multi-territorial regions, suggesting systemic thromboembolism. An elevated level of D-dimers, C-reactive protein, ferritin, lactic acid dehydrogenase, troponin, ESR, fibrinogen, and a positive antiphospholipid antibody were also noted in this review. Conclusions: The occurrence of stroke in patients with COVID-19 infection is uncommon, but it may pose as an important prognostic marker and indicator of severity of infection, by causing large vessels occlusion and exhibiting a thrombo-inflammatory vascular picture. Physicians should be made aware and remain vigilant on the possible two-way relationship between stroke and COVID-19 infection. The rate of stroke among patients with COVID-19 infection may increase in the future as they share the common risk factors.

Matched MeSH terms: Prognosis
Fulltext Antiretroviral treatment-associated labia majora lipohypertrophy: A rare case and plastic surgical treatment options

Akmal Hisham, Devananthan Ilenghoven, Wan Syazli Wan Ahmad Kamal, Salina Ibrahim, Shah Jumaat Mohd Yussof

Journal of Clinical and Health Sciences, 2017;2:43-47.

The emergence of highly active antiretroviral therapy (HAART) has revolutionized the prognosis of HIV-infected patients. However, the extended use of HAART is associated with a disfiguring complication termed lipodystrophy, a disorder of body fat maldistribution causing peripheral fat loss (lipoatrophy) and central fat accumulation (lipohypertrophy). Lipoatrophy commonly affects the face, legs, buttocks and arm, whilst lipohypertrophy frequently favours the abdomen, breast and dorsocervical region. To our knowledge, we present only the second documented case in the literature of a labia majora lipohypertrophy in a HIV-positive patient receiving long-term HAART. The severity of labial abnormality caused significant physical and functional morbidities. Labiaplasty with dermolipectomy of the labia majora and excisional lipectomy of the mons pubis was successfully performed. At a 6-month follow-up, patient had no recurrence with resolution of symptoms and resumption of normal activities of daily living (ADL).

Matched MeSH terms: Prognosis
Fulltext Antenatal traumatic brain injury secondary to maternal motor vehicle accident

Shamala N., Faizal, A.H.

Medicine & Health, 2018;13(2):202-207.
MyJurnal

Trauma is thought to complicate 1 in 12 pregnancies. The management of trauma during pregnancy requires special consideration because pregnancy alters maternal physiology and the foetus is a potential collateral victim. The approach of these cases in the setting of the Emergency Department should not only be diagnostic for any foetal injuries but also prognostic for any future undue outcome. Antenatal traumatic brain injury is a rare but real complication of maternal blunt force trauma. Our case involves a 22-year-old primigravida who suffered a motor vehicle accident and on initial assessment revealed normal foetal assessment but subsequently after premature labour revealed a new born with traumatic brain injury. Early ultrasonographic evaluation and observational period with continuous electronic foetal monitoring may improve the detection and emergent treatment in these cases.

Matched MeSH terms: Prognosis
Candida Skull Base Osteomyelitis: a Case Report and Literature Review

Krishnamoorthy M, Othman NAN, Hassan NEB, Hitam SB

Acta Medica (Hradec Kralove), 2020;63(2):82-85.
PMID: 32771074 DOI: 10.14712/18059694.2020.22

Skull base osteomyelitis (SBO) also commonly known as malignant otitis externa was first described by Meltzer and Kelemen in 1959. Prior to the advent of the antibiotic era, this disease carried a poor prognosis with significant morbidity. It often proved fatal with mortality rates as high as 50%. Commonly seen in the immunocompromised patients, diabetes mellitus is an important associated comorbidity in the pathophysiologic development of this disease. Treatment is instituted by medical therapy with surgery having a limited role. Surgical intervention has a limited role, for example, in fungal SBO. Such cases may require local debridement and intraoperative tissue biopsies for histopathologic confirmation. This is to demonstrate fungal invasion into the skull base, as well as to exclude other sinister differential diagnoses like squamous cell carcinoma of temporal bone. In this case report, we present a rare case of candida SBO and the literature review.

Matched MeSH terms: Prognosis
Fulltext Diagnostic and Prognostic Indications of Nasopharyngeal Carcinoma

E A R ENS, Irekeola AA, Yean Yean C

Diagnostics (Basel), 2020 Aug 19;10(9).
PMID: 32825179 DOI: 10.3390/diagnostics10090611

Nasopharyngeal carcinoma (NPC) is a disease that is highly associated with the latent infection of Epstein-Barr virus. The absence of obvious clinical signs at the early stage of the disease has made early diagnosis practically impossible, thereby promoting the establishment and progression of the disease. To enhance the stride for a reliable and less invasive tool for the diagnosis and prognosis of NPC, we synopsize biomarkers belonging to the two most implicated biological domains (oncogenes and tumor suppressors) in NPC disease. Since no single biomarker is sufficient for diagnosis and prognosis, coupled with the fact that the known established methods such as methylation-specific polymerase chain reaction (PCR), multiplex methylation-specific PCR, microarray assays, etc., can only accommodate a few biomarkers, we propose a 10-biomarker panel (KIT, LMP1, PIKC3A, miR-141, and miR-18a/b (oncogenic) and p16, RASSF1A, DAP-kinase, miR-9, and miR-26a (tumor suppressors)) based on their diagnostic and prognostic values. This marker set could be explored in a multilevel or single unified assay for the diagnosis and prognosis of NPC. If carefully harnessed and standardized, it is hoped that the proposed marker set would help transform the diagnostic and prognostic realm of NPC, and ultimately, help prevent the life-threatening late-stage NPC disease.

Matched MeSH terms: Prognosis
Fulltext The expression of microrna-744 (Mir-744) in nasopharyngeal carcinoma: a preliminary study

Noor Syamila Othman, Wan Ishlah Leman, Kahairi Abdullah, Siti Aesah @ Naznin Muhammad, Mohd Arifin Kaderi

International Journal of Allied Health Sciences, 2018;2(1):191-203.
MyJurnal

The aim of this study was to investigate the level of miR-744 expression in nasopharyngeal carcinoma (NPC) tumour tissue and to provide initial clue on its potential as biomarkers for early detection of NPC in a preliminary analysis. Total miRNAs was extracted from NPC tissue as well as normal nasopharynx tissue taken from Hospital Tengku Ampuan Afzan (HTAA), Kuantan and converted into cDNA. The level of miR-744 expression in the cDNA was quantified using quantitative reverse transcription polymserase chain reaction (RT-qPCR) technique. The expression level of SNORD48 was measured simultaneously for each sample, which served as endogenous control. The difference in the expression of miR-744 in NPC and normal nasopharynx tissue were analysed using relative quantification, 2-ΔΔCT. In this preliminary analysis, this study found that miR-744 was upregulated in NPC as compared to normal nasopharynx tissue by 2.5 fold changes, respectively suggesting it may involve in progression of tumour. However, the finding is not significant and may not accurately reflect the overall population, due to small sample size involved in the study. Findings from the current study suggest the potential of miR-744 to serve as useful diagnostic and prognostic biomarker in NPC.

Matched MeSH terms: Prognosis
Clinical significance of aberrant microRNAs expression in predicting disease relapse/refractoriness to treatment in diffuse large B-cell lymphoma: A meta-analysis

Ting CY, Liew SM, Price A, Gan GG, Bee-Lan Ong D, Tan SY, et al.

Crit Rev Oncol Hematol, 2019 Dec;144:102818.
PMID: 31733445 DOI: 10.1016/j.critrevonc.2019.102818

The clinical significance of aberrantly expressed microRNAs in predicting treatment response to chemotherapy in diffuse large B-cell lymphoma patients (DLBCL) remains uncertain. Feasibility of microRNA testing to predict treatment outcome was evaluated. Twenty-two types of aberrantly expressed microRNAs were associated with poor treatment response; pooled hazard ratio (HR) was 2.14 [95%CI:1.78-2.57, P

Matched MeSH terms: Prognosis
Fulltext Fat-Soluble Vitamins and the Current Global Pandemic of COVID-19: Evidence-Based Efficacy from Literature Review

Samad N, Dutta S, Sodunke TE, Fairuz A, Sapkota A, Miftah ZF, et al.

J Inflamm Res, 2021;14:2091-2110.
PMID: 34045883 DOI: 10.2147/JIR.S307333

The outbreak of pneumonia caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), later named COVID-19 by the World Health Organization (WHO), was initiated at Wuhan, Hubei, China, and there was a rapid spread of novel SARS-CoV-2 and the disease COVID-19 in late 2019. The entire world is now experiencing the challenge of COVID-19 infection. However, still very few evidence-based treatment options are available for the prevention and treatment of COVID-19 disease. The present review aims to summarize the publicly available information to give a comprehensive yet balanced scientific overview of all the fat-soluble vitamins concerning their role in SARS-CoV-2 virus infection. The roles of different fat-soluble vitamins and micronutrients in combating SARS-CoV-2 infection have been recently explored in several studies. There are various hypotheses to suggest their use to minimize the severity of COVID-19 infection. These vitamins are pivotal in the maintenance and modulation of innate and cell-mediated, and antibody-mediated immune responses. The data reported in recent literature demonstrate that deficiency in one or more of these vitamins compromises the patients' immune response and makes them more vulnerable to viral infections and perhaps worse disease prognosis. Vitamins A, D, E, and K boost the body's defense mechanism against COVID-19 infection and specifically prevent its complications such as cytokine storm and other inflammatory processes, leading to increased morbidity and mortality overemphasis. However, more detailed randomized double-blind clinical pieces of evidence are required to define the use of these supplements in preventing or reducing the severity of the COVID-19 infection.

Matched MeSH terms: Prognosis
Fulltext Primary large B cell lymphoma of the parotid gland: case report

Almothafar, B., Wong, L., Noorafidah, M.D.

JUMMEC, 2011;14(1):26-30.
MyJurnal

Primary parotid lymphoma is uncommon and rarely suspected. In most cases, the disease would have disseminated at the time of diagnosis. We describe a case of primary non-Hodgkin’s lymphoma of the parotid gland which progressed to the central nervous system. Clinical history is of limited value in identifying this condition. Diagnostic imaging studies (CT or MRI) may indicate whether or not the mass is salivary in origin but do not help to confirm the diagnosis. In this case, it was deemed that FNA alone is incapable of determining the precise histological subtype for lymphoma, whilst a tru-cut biopsy demonstrated a more sensitive method of determining the diagnosis. The lessons learned from this case would prove useful for other health care providers to make an early diagnosis and hopefully manage more effectively if similar conditions appear in their practice. Performing the appropriate measures can help to not only improve the prognosis but may even avert the prospect of unnecessary surgery.

Matched MeSH terms: Prognosis
Fulltext The rare primary Low Grade Papillary Adenocarcinoma of Nasopharynx: a diagnostic challenge and management

Noor Dina, H., Gendeh, B.S.

Medicine & Health, 2015;10(2):137-140.
MyJurnal

Low Grade Papillary Nasopharyngeal Adenocarcinoma (LGPAC) is a very rare tumour of mucosal origin compared to a higher incidence of well differentiated keratinized/non-keratinized nasopharyngeal carcinoma. It is an epithelial tumour with glandular differentiation. Its papillary figure seen histologically, is also seen in metastatic papillary thyroid carcinoma. This has caused a significant challenge to the Pathologist to differentiate primary papillary nasopharyngeal adenocarcinoma and metastatic tumour. Thyroid Transcription Factor-1 (TTF-1) is also expressed in subsets of papillary nasopharyngeal adenocarcinoma, which is valuable as a diagnostic tool. LGPAC is a benign-like malignant neoplasm. An early diagnosis with a complete tumour removal via conventional excision or endoscopic approach has offered a good prognosis with low risk of recurrence.

Matched MeSH terms: Prognosis
Fulltext Coronary artery spasm: A quandary

Ngow, H.A., Wan Khairina, W.M.N.

International Medical Journal Malaysia, 2011;10(1):53-55.
MyJurnal

Coronary artery spasm can result in acute coronary syndrome. This vasospastic syndrome can cause profound morbidity and mortality as a significant proportion of patients continue to have angina despite optimal medical therapy. We illustrate the dilemma in managing a young woman who presented with non ST-segment myocardial infarction as a result of it. She did not have the conventional risks for coronary artery disease except the family history of myocardial infarction. Vasospasm was demonstrated at the mid right coronary artery which resolved with intracoronary nitroglycerine during angiogram. Most women with no significant heart disease following demonstration of normal or “near normal” coronary arteries after angiography are offered no treatment beyond reassurance each year. New data suggest that this approach may no longer be appropriate and the prognosis in such patient is not as benign as previously thought. We discuss the management dilemma of such patient with associated mild atherosclerotic plaque.

Matched MeSH terms: Prognosis
Fulltext Diagnostic dilemma in metaplastic chondroid breast carcinoma

Farina, M.Y., Shahrun Niza, A.S., Saladina, J.J., Nani Harlina, M.L., Zaireen, M.N., Nurismah, M.I., et al.

International Medical Journal Malaysia, 2014;13(1):65-68.
MyJurnal

Metaplastic breast cancer is a rare form of primary breast cancer. It contains a mixture of adenocarcinoma with metaplastic elements. It is important to differentiate with primary sarcoma of the breast which carries different treatment strategies and prognosis. A 55-year-old lady previously diagnosed to have a left breast cancer in the year 2000 and carcinoma of the endometrium in 2009, presented with a right breast lump. A trucut biopsy reported as an infiltrating ductal carcinoma with background of chondromyxoid and cartilagenous matrix,
most probably metaplastic carcinoma. A wide local excision with sentinel lymph node biopsy was performed, and the final histology was consistent with metaplastic chondroid carcinoma of the breast with no evidence of metastsis. The surgery was followed by adjuvant radiotherapy and currently free from any recurrence. The diagnostic dilemma on this very rare condition is reviewed.

Matched MeSH terms: Prognosis

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