MyMedR

Erysipelothrix rhusiopathiae endocarditis presenting with stroke

Tan YA, Ng KC, Cheo SW, Low QJ, Chia YK

QJM, 2020 07 01;113(7):485-487.

PMID: 32053172 DOI: 10.1093/qjmed/hcaa025

A case of arrhythmogenic right ventricular cardiomyopathy with right ventricle thrombus: A case report

Low QJ, Siaw C, Cheo SW, Kim HS, Benjamin Leo CL, Norliza O, et al.

Med J Malaysia, 2020 07;75(4):452-454.

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare inherited cardiomyopathy characterised by right ventricular dysfunction, ventricular arrhythmias and increased risk of sudden cardiac death. Due to the replacement of myocardium with fibro-fatty and fibrous tissue, patients with ARVC are prone to develop ventricular tachycardia. Histologically, it is often reported as the 'triangle of dysplasia' involving the inflow tract, outflow tract and apex of the right ventricle.2 We describe a 20-years-old patient who collapsed during a futsal match and was subsequently diagnosed to have ARVC with a right ventricular thrombus from cardiac magnetic resonance imaging.

Dilemma in the management of methanol poisoning at a district hospital in Malaysia

Low QJ, Lee KT, Lim TH, Siaw C, Cheo SW, Tan NE, et al.

Med J Malaysia, 2020 07;75(4):442-444.

PMID: 32724013

There are increasing reports of methanol poisoning (MP) incidence worldwide. In Malaysia, the largest first methanol poisoning was reported in Selangor in 2013 with a total of 41 patients and cluster of cases been reported from the country since then. Often MP involved adulterated alcohol containing more than the legal permissible concentration of methanol. Methanol is rapidly absorbed and metabolised into formic acid which causes variable symptoms of the central nervous system such as blindness, seizure, coma and gastrointestinal disturbances. Mortality could reach up to 83% as reported using the coma state, pH and pCO2 level in the worst-case scenario.

A case of severe Plasmodium knowlesi malaria in a post-splenectomy patient

Cheo SW, Khoo TT, Tan YA, Yeoh WC, Low QJ

Med J Malaysia, 2020 07;75(4):447-449.

PMID: 32724015

Malaria is a parasitic disease that is caused by the Plasmodium parasite. Worldwide, it remains a significant public health problem especially in the Africa region where it contributes to more than 90% of cases and malaria death. However, zoonotic (simian) Plasmodium knowlesi parasite is a widely prevalent cause of malaria in the South East Asian countries. It is known to cause severe human disease due to its 24hour erythrocytic cycles. Thus far, cases of severe falciparum malaria have been reported in asplenic patients. Here, we report a case of severe P.knowlesi malaria in a 51-year-old man who is a postsplenectomy patient.

Interstitial pneumonia with autoimmune features

Low QJ, Teo KZ, Thien LK, Lim TH, Cheo SW

J R Coll Physicians Edinb, 2020 12;50(4):387-391.

PMID: 33469613 DOI: 10.4997/JRCPE.2020.407

BACKGROUND: Cardiac tamponade is a medical emergency. This study was carried out to determine the etiologies of cardiac tamponade and review the management and outcomes.

METHODS: We retrospectively analysed case records of patients who underwent pericardiocentesis for cardiac tamponade during the two consecutive years (1 January 2018 to 31 December 2019) at Hospital Sultanah Nora Ismail, Batu Pahat, in Johor, Malaysia.

RESULTS: There were ten patients (eight males, two females; age range 20 to 70 years old, mean age 36 years old) who underwent pericardiocentesis for cardiac tamponade during the said period. Malignancy (40%), tuberculosis (30%), idiopathic (20%), and bacterial (10%) were among the common causes of the pericardial effusion in this center. The commonest symptoms were breathlessness (90%), chest pain (60%), cough (50%), and unexplained fever (20%). Pulsus paradoxus was the most speciÿ c sign (100%) for the presence of echocardiographic feature of cardiac tamponade. Two of the patients with tuberculous pericarditis had retroviral disease; one patient had bacterial pericarditis due to salmonella typhi.

CONCLUSION: This study has conÿ rmed that there are many etiologies and presentation of cardiac tamponade; clinicians should be alert as urgent pericardiocentesis is lifesaving.

Familial neuromyelitis optica spectrum disorder in a pair of sisters

Cheo SW, Ong SAM, Low QJ, Tan YA, Chia YK

QJM, 2020 Oct 01;113(10):743-746.

PMID: 32240316 DOI: 10.1093/qjmed/hcaa107

Immune reconstitution inflammatory syndrome and human immunodeficiency virus infection

Cheo SW, Ahmad Akbar RZ, Abd Rahman F, Abdul Rashid WNF', Tan YA, Low QJ

QJM, 2020 Nov 01;113(11):809-812.

PMID: 32275748 DOI: 10.1093/qjmed/hcaa122

Case series of haemothorax secondary to avulsed bullae vessel

Low QJ, Hatta Z, Cheo SW, Syed RSH, Goh KS

Med J Malaysia, 2019 Oct;74(5):431-432.

PMID: 31649221

Haemothorax refer to the bleeding in the pleural space. It is commonly due to iatrogenic, blunt or penetrating chest trauma. Non-traumatic haemothorax is a rare entity that can potentially lead to life threatening complications. The initial management of both traumatic and non-traumatic haemothorax includes resuscitation and stabilisation of the patient. We would like to present two cases of non-traumatic haemothorax secondary to an avulsed bullae vessel.

Response to: Stroke and infective endocarditis

Tan YA, Ng KC, Cheo SW, Low QJ, Chia YK

QJM, 2020 07 01;113(7):517-518.

PMID: 32191336 DOI: 10.1093/qjmed/hcaa099

Acute necrotizing encephalopathy in a child secondary to dengue fever: A case report

Cheo SW, Low QJ, Teh YG, Rajahram GS, Mohd Zain NR, Chia YK

Med J Malaysia, 2021 Sep;76(5):750-752.

PMID: 34508389

Dengue fever (DF) is an important public health problem, and it is now endemic in more than 100 countries worldwide. Dengue associated neurological complication is estimated to be affecting 0.5 to 6.2% of patients. Even though this is rare, neurological manifestation of DF is an increasingly recognized entity in recent years due to significant mortality and morbidity reported/seen. Reported central nervous system manifestations due to dengue include encephalitis, encephalopathy, myelitis, myositis, acute disseminated encephalomyelitis, Guillain-Barré syndrome, stroke and etc. We report here a case of acute necrotizing encephalopathy secondary to DF in a previously healthy 12-year-old girl.

Fulltext Posterior reversible encephalopathy syndrome secondary to dengue fever: a case report

Cheo SW, Wong HJ, Ng EK, Low QJ, Chia YK

Hong Kong Med J, 2021 02;27(1):55-57.

PMID: 33568560 DOI: 10.12809/hkmj208509

Fulltext Erythematous plaques of the vulvo-perineal region

Low QJ, Lim TH, Hon SA, Cheo SW, Wagino N, Yap EWL

Malays Fam Physician, 2021 Nov 30;16(3):101-103.

PMID: 34938398 DOI: 10.51866/cr1276

Skin conditions are a common reason for consulting primary health care. The public frequently expects their primary health care providers to be able to recognise and treat common skin conditions with confidence. Primary care providers must be able to identify 'red flag' skin conditions that require dermatology referral. However, diagnosis is often delayed due to the non-specific clinical presentation, low incidence, slow evolution and long-term history of such lesions. We report the case of a patient with extramammary Paget's disease that presented to her primary care provider and subsequently underwent a wide local excision.

Fulltext Haemophagocytic lymphohistiocytosis secondary to dengue fever: a case report

Cheo SW, Abdul Rashid WNFA, Ho CV, Ahmad Akhbar RZ, Low QJ, Rajahram GS

Hong Kong Med J, 2021 08;27(4):287-289.

PMID: 34413256 DOI: 10.12809/hkmj208815

Hepatic Sarcoidosis: Diagnostic approach and management

Hon SA, Lee LT, Tan KK, Lee RA, Low QJ

Med J Malaysia, 2021 Nov;76(6):914-917.

PMID: 34806684

Sarcoidosis is a multi-systemic, non-caseating granulomatous disorder with an idiopathic aetiology. We report a 58-year-old Malay woman, with underlying type II diabetes mellitus, hypertension and history of stage II pulmonary sarcoidosis presenting with incidental finding of multiple hypodense liver lesions. Her recent contrasted enhanced computed tomography of the abdomen and pelvis demonstrated multiple intra-abdominal lymphadenopathies with evidence of liver and splenic infiltrations. Her ageappropriate malignancy screening was negative while liver biopsy showed non-caseating granulomatous hepatitis consistent with hepatic sarcoidosis. In view of her normal liver enzymes and normalised serum calcium levels, no immunosuppressive therapy was commenced. She remains asymptomatic and is currently under our close monitoring.

Fulltext A case of dapsone-induced methaemoglobinaemia

Tan YA, Ng KC, Cheo SW, Khoo TT, Low QJ

Clin Med (Lond), 2020 Sep;20(5):519-521.

PMID: 32934050 DOI: 10.7861/clinmed.2020-0364

Methaemoglobinaemia is an uncommon but potentially serious condition. It can be caused by congenital or acquired cause. Drug-induced methaemoglobinaemia is the commonest cause of acquired methaemoglobinaemia. The clinical signs and symptoms of methaemoglobinaemia include dyspnoea, desaturation, presence of saturation gap, headache, nausea and seizures depending on level of serum methaemoglobinaemia. We illustrate a case of dapsone-induced methaemoglobinaemia and its successful treatment by intravenous methylene blue.

Dermatomyositis and nasopharyngeal carcinoma

Low QJ, Hon SA, Garry Siow PW, Lim TH, Lee RA, Tan YA, et al.

QJM, 2020 Oct 01;113(10):753-754.

PMID: 31995198 DOI: 10.1093/qjmed/hcaa014

Displaying publications 21 - 36 of 36 in total