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Primary Eustachian Tube Tuberculosis

Hamzah MH, Mohamad I, Mutalib NSA

Medeni Med J, 2021;36(2):172-175.
PMID: 34234985 DOI: 10.5222/MMJ.2021.52460

Nasopharyngeal tuberculosis is a rare occurrence, and primarily involves the proximal part of the Eustachian tube. Mechanical obstruction of the Eustachian tube will affect the pressure discrepancy between the middle ear and the external atmosphere, leading to aural fullness, unilateral hearing disturbance, and otitis media. These conditions can be overlooked or mistakenly diagnosed as ear pathology. We report a case of unilateral hearing loss and tinnitus in a 31-year-old healthy woman that was later confirmed to be tuberculosis of the Eustachian tube. In cases with indicators suggesting a high index of suspicion, a thorough examination of the head and neck regions is especially very important. Once it has been diagnosed, Eustachian tuberculosis can be successfully treated with anti-tuberculosis medications.
Fulltext Extracardiac Rhabdomyoma Mimicking Plunging Ranula

Hakim I, Yunus MRM

Medeni Med J, 2020;35(3):271-275.
PMID: 33110681 DOI: 10.5222/MMJ.2020.88120

Histopathologically adult extracardiac rhabdomyoma is a benign tumour of mature striated muscle. It is a slow- growing tumour with predilection to occur in head and neck region. They appear mainly as a solitary lesion, and about 15% of them can be multicentric. A 56-year-old man presented to us with the floor of mouth swelling persisted for one year and the right neck swelling for three years mimicking a plunging ranula. Radiological imaging revealed enhancing mass at the floor of mouth and submandibular region. The mass represented a nonvascular benign tumour. Subsequently, the patient underwent excision of the mass via transcervical and transoral method. Histopathological examination revealed adult type of extracardiac rhabdomyoma. Adult type of extracardiac rhabdomyoma should be considered in the differential diagnosis for the head and neck masses. A complete excision will reduce the risk of recurrence.
Kimura Disease with Parotid Swelling and Cervical Lymphadenopathy: A Case Report and Literature Review

Eh Dam VSK, Mohamad S, Mohamad I

Medeni Med J, 2020;35(2):170-174.
PMID: 32733768 DOI: 10.5222/MMJ.2020.84594

Kimura disease (KD) is a rare chronic benign inflammatory disorder of unknown etiology that is prevalent in Asian males. The head and neck region, especially the parotid glands and cervical lymph nodes, are most commonly affected. Diagnosis is based on clinicopathological features, while radiology findings are nonspecific. Although various treatment strategies have been proposed, there is a high recurrence rate. Combination therapy has been found to produce better results than monotherapy. We present a case of KD with huge parotid and cervical lymph node involvement that was treated with a combination of surgery and corticosteroids administered perioperatively.
Fulltext A Rare Intraorbital Mass: An Isolated Mucocele

Che Mat CMH, Mustapha F, Noor RM, Ramli R, Mohamad I

Medeni Med J, 2020;35(4):344-348.
PMID: 33717628 DOI: 10.5222/MMJ.2020.01057

Mucocele is a mucous filled benign cystic lesion. It develops due to obstruction of any natural os-tium of the paranasal sinus. Even though being benign, it has capability to erode and cause thinning the adjacent bony structures. Isolated intraorbital mucocele without paranasal sinus disease is a rare condition. We present a 39-year-old female patient with right medial canthal swelling without any nasal symptoms, and normal nasoendoscopic finding. Imaging revealed the lesion as a right ethmoidal mucocele with normal paranasal sinuses. However intraoperatively, it was an isolated intraorbital lesion, lateral to lamina papyracea with thick-yellowish mucin discharge.
Fulltext Knowledge, attitude and practice on diabetic wound care management among healthcare professionals and impact from a short course training in Sabah, Borneo

Bondi ME, Rahim SSSA, Avoi R, Hayati F, Ahmedy F, Omar A, et al.

Medeni Med J, 2020;35(3):188-194.
PMID: 33110670 DOI: 10.5222/MMJ.2020.02929

Objective: Healthcare professionals with an advanced level of knowledge and skills on diabetic wound care management are needed to effectively manage complex wounds. This study aimed to determine the effects of an educational intervention to enhance the management of wound care among healthcare professionals.

Method: This study was part of a quasi-experimental pre-post research design where 82 healthcare professionals were recruited and assigned to intervention and control groups. The participants in the intervention group attended two days of educational intervention training on diabetic wound care management, while there was no intervention in the control group. A questionnaire on knowledge, attitude, and practice was applied before and one-month post-intervention to both groups.

Results: Pre-test resulted in a low level of knowledge 72.1% and 74.4%, negative level of attitude 67.4% and 66.7%, and a moderate level of practice 79.1% and 76.9% in both intervention and control groups respectively. Post-test resulted in increasing levels of knowledge (76.7%), positive attitude (100%), and practice (76.7%) in the intervention group. At the same time, there was no significant change in the control group. Repeated Measure ANOVA for within-subject and between-subject effects resulted in a statistically significant p-value of 0.001 for knowledge, attitude, and practice after the educational intervention.

Conclusion: Health professionals have only a moderate level of knowledge on diabetic wound care management. It is important to improve this level by specific trainings and by using a good training module.
Fulltext Posterior Ethmoid Nodular Fasciitis

Baki AM, Ramli R, Noor RM, Mohamad I, Jais M

Medeni Med J, 2020;35(3):276-280.
PMID: 33110682 DOI: 10.5222/MMJ.2020.90093

Nodular fasciitis (NF) is an uncommon and benign tumour-like fibroblastic proliferation that is difficult to distinguish from sarcoma both clinically and histologically. In addition, it is a type of lesion characterised by having a potential for spontaneous regression. NF is frequently misdiagnosed due to its rapid growth, rich cellularity, and mitotic figure. Although NF is only rarely diagnosed in children, the head and neck represent the most common locations for NF among this population. The cause of NF remains unknown, however trauma is believed to be an important triggering factor. We describe an unusual case of NF in the posterior ethmoid sinus in a six-year-old boy with no history of trauma. The NF was incidentally noted on a computed tomography scan after the patient complained of a squint. The diagnosis of NF was also supported by histopathology and specific immunohistological staining. A surgical biopsy was performed, and no recurrence was observed after one year.
The Prevalence of Hearing Loss Among Babies in the Neonatal Intensive Care Unit in a Tertiary Hospital in Malaysia

Abdullah A, Dahari KASA, Tamil AM, Rohana J, Razif MYM, Shareena I

Medeni Med J, 2020;35(2):116-120.
PMID: 32733760 DOI: 10.5222/MMJ.2020.68466

Objective: To study the prevalence of hearing loss (HL) and to identify the possible risk factors causing HL.
Methods: This retrospective study was conducted from January 2014-December 2016 at a tertiary hospital in Malaysia. All neonates admitted to the neonatal intensive care unit (NICU), Universiti Kebangsaan Malaysia Medical Centre (UKMMC) were screened with a two-step protocol using an automated auditory brain response (AABR) and/or Otoacoustic Emission and auditory brain response (ABR). Descriptive analysis was used for the prevalence of HL, degree of HL and number of risk factors per infant.
Results: A total of 2713 babies underwent hearing screening in NICU was enrolled in this study. Two thousand six hundred eight (96%) babies passed the screening test and 214 (4%) babies required further diagnostic test. Only 105 (49%) babies completed diagnostic tests. Out of 105 babies, 40 (38.1%) babies had HL. Mild HL was the commonest HL with 22 (55%), moderate HL was in seven babies (17.5%), severe HL in two babies (5%), and profound HL in nine babies (22.5%). The presence of craniofacial anomalies was the only significant independent risk factor for HL with p<0.05 with an odds ratio of 0.105 CI 95% [0.028-0.389]. Of Babies with the presence of three or more risk factors, 100% of them had HL.There was an increased risk of hearing loss in those with craniofacial anomalies up to 11 times higher compared to those without such anomalies.
Conclusion: The prevalence of HL among the NICU babies was 1.5% and mild HL was the commonest degree of HL (55%).