MyMedR

Fulltext Primary hyperparathyroidism--a clinical study

Goh KL, Wang F

Med J Malaysia, 1988 Sep;43(3):206-12.

PMID: 3241578

Matched MeSH terms: Middle Aged

Melioidosis with brain abscess

Pit S, Chea FK, Jamal F

Postgrad Med J, 1988 Feb;64(748):140-2.

PMID: 3174527

Central nervous system involvement in melioidosis is rare. We describe a 48 year old woman who developed septicaemia and a brain abscess due to Pseudomonas pseudomallei. Since there is a continuing practical problem in bacteriological confirmation of the aetiological agent, diagnosis of melioidosis has to be made on clinical suspicion.

Matched MeSH terms: Middle Aged

Fulltext Experience with primary myelodysplastic syndromes in a university haematology unit: report of five cases

Cheong SK, Ainoon O

Med J Malaysia, 1987 Dec;42(4):272-5.

PMID: 3454399

Myelodysplastic syndromes appear to be a rare group of blood disorders in Malaysia. It usually affects the elderly and some of the cases were reported to evolve into acute leukemia. We describe our experience with five cases, seen and managed by us over a 5-year period. All patients receiving supportive therapy died with one of them definitely known to transform to acute leukemia. The patient who survives till the time of writing received low dose continuous cytosine arabinoside infusion.

Matched MeSH terms: Middle Aged

Fulltext Benign migratory glossitis--a cause for worry?

Yaacob HB

Med J Malaysia, 1981 Dec;36(4):246-9.

PMID: 7334963

child and two elderly females with benign migratory glossitis (BMG) are presented. The aetiology is unknown, but emotional stress, mechanical and chemical trauma are important in the production of pain in an initially asymptomatic BMG. Treatment consists of reassurance, avoidance of hot, spicy and highly-seasoned foods. Any underlying reactive depression must be treated.

Matched MeSH terms: Middle Aged

The prevalence of silicosis among Chinese tombstone makers in Malaysia

Singh A, Jorgensen HS

Med J Malaysia, 1978 Jun;32(4):294-6.

PMID: 732625

Matched MeSH terms: Middle Aged

The management of residual bile duct calculi

Salleh HB

Med J Malaysia, 1975 Mar;30(3):195-201.

PMID: 1160678

Matched MeSH terms: Middle Aged

[Mycobacterial lung infection in 8 patients with AIDS: clinical and radiological features]

Kawana A, Toyota E, Kobayashi N, Kudo K, Genka I, Aoki M, et al.

Kansenshogaku Zasshi, 1998 Mar;72(3):238-44.

PMID: 9585697

The prevalence of mycobacterial infection in AIDS patients has increased in Japan. This report describes details of the clinical and radiological features of eight AIDS patients with mycobacterial disease (6 with M. tuberculosis infection and 2 with M. kansasii infection) in our hospital during the period from October 1995 through February 1997. Six of the 8 were men, and two were women. The mean age was 36.5 years. Six were Japanese, one was from Myanmar, and one was Malaysian. The median CD4 positive T lymphocyte counts (CD4 count) at the time of diagnosis of the M. tuberculosis was 75.5 (range 14-569/microliter, and the M. kansasii was 21.5 (range 19-24)/microliter. Clinical findings and symptoms of all patients were non-specific, but almost all patients had a cough and fever. In the radiographic findings, the patients of the M. tuberculosis group presented multiple hilar and mediastinal lymphadenopathy, miliary shadow, and obstructive pneumonia. Both M. kansasii patients showed a multiple infiltration shadow. There were no drug resistant strains in M. tuberculosis except on isolate with moderate resistant. to Streptomycin. These observations suggest that AIDS-associated mycobacterial disease shows atypical clinical and radiological features in some cases, especially in advanced stages of AIDS. Therefore, we need to recognize the characteristics of the clinical and radiological features of the patients with mycobacterial diseases and AIDS.

Matched MeSH terms: Middle Aged

The role of growth differentiation factor 15 as a predictor of 5-year survival of patients after acute coronary syndrome

Vyshnevska IR, Kopytsya MP, Kutya IM, Protsenko OS

Pol Merkur Lekarski, 2020 Oct 23;48(287):297-301.

PMID: 33130786

One of the problems of modern cardiology in Ukraine and the world is acute coronary syndrome (ACS), which results in high mortality and invalidation of patients. Recently, much attention is drawn to the growth differentiation factor 15 (GDF-15). A lot of studies provided, in which the role of GDF-15 in cardiovascular pathology proved.

AIM: The aim of the study was to determine the predictive possibility of the GDF-15 marker in the stratification of the ACS complications risk within 5 years after the event.

MATERIALS AND METHODS: 70 patients with ACS were involved. The mean age was (61.8 +/- 1.3) years, the following diagnosis was established in the patients: 76 patients had acute myocardial infarction with Q (AMI with Q), 28 - acute myocardial infarction without Q (AMI without Q) and 36 patients were diagnosed unstable angina (UA). During the follow-up period the endpoint was reached by 28 patients.

RESULTS: A statistical relationship between the elevated level of GDF - 15 and the 5-year survival of these patients (χ2 = 4.75, p = 0.03) has been found. It was established that the level of the GDF-15 biomarker > 2350 pg/ml independently predicted the onset of adverse events with the sensitivity of 80% and the specificity of 60% (p = 0.006). To investigate the influence of the GDF-15 levels on mortality in the remote period, the Cox regression analysis was performed. It was revealed that the level of GDF-15 significantly predicted the onset of the primary endpoint within 5 years after ACS (p = 0.004).

CONCLUSIONS: The increased level of GDF-15, determined in the first 24 hours after development of ACS, is highly associated with the adverse outcome within 5 years after the event.

Matched MeSH terms: Middle Aged

Fulltext An Infratemporal Meningioma: A Diagnostic Dilemma

Kaur A, Ali R, Omar E, Hashim H

J Radiol Case Rep, 2021 Jan;15(1):1-10.

PMID: 33717402 DOI: 10.3941/jrcr.v15i1.3898

A 46-year-old male presented with painless, recurrent bilateral ear discharge and an enlarging right temporal swelling. There were no neurological deficits. Imaging revealed an enhancing, soft tissue mass at the right infratemporal region involving the right temporalis muscle with a small, enhancing intradural component and associated hyperostosis of the greater wing of the right sphenoid bone. Tumour debulking of the right temporalis tumour was performed. Tumour invasion of the right temporalis muscle was noted intraoperatively. Histopathological result was consistent with fibrous meningioma WHO Grade 1 involving surgical resection margins. Follow-up MRI revealed residual right temporal extracranial component. Thus, plans were made for a second stage tumour debulking, however at time of writing, surgery had not been performed. This case highlights the differing appearances of the common meningioma occurring extracranially with elaboration of its differential diagnosis and management.

Matched MeSH terms: Middle Aged

Parathyroid hormone-dependent familial hypercalcemia with low measured PTH levels and a presumptive novel pathogenic mutation in CaSR

Mahajan A, Buse J, Kline G

Osteoporos Int, 2020 Jan;31(1):203-207.

PMID: 31641801 DOI: 10.1007/s00198-019-05170-9

Familial hypocalciuric hypercalcemia (FHH) is a benign autosomal dominant condition characterized by lifelong asymptomatic hypercalcemia. FHH is typically caused by a heterozygous inactivating mutation of the calcium-sensing receptor (CaSR) and characterized by moderate hypercalcemia, inappropriately normal or elevated serum parathyroid hormone (PTH), and relative hypocalciuria (FeCa 2%. PTH levels were repeatedly below the mean of the reference range (on two separate assays) and sometimes even below the lower reference limit. Two siblings, one niece, and her son had hypercalcemia without nephrolithiasis. Cinacalcet, used as a PTH-suppression test, normalized serum total and ionized calcium after 7 days of cinacalcet 30 mg BID, confirming her hypercalcemia was PTH-mediated. Given her family history, genetic testing was pursued and discovered a novel pathogenic mutation of the CaSR gene confirming the diagnosis of FHH type 1. Our case represents an atypical presentation of FHH1 with low PTH and FeCa > 2%. This contributes to the expanding clinical and biochemical spectrum of CaSR inactivating mutations and presents an innovative approach to evaluating biochemically uncertain familial hypercalcemia with cinacalcet before pursuing expensive genetic analysis.

Matched MeSH terms: Middle Aged

Paraneoplastic optic neuropathy secondary to adenocarcinoma of the lung

Yap JY, Wan HItam WH, Abdul Halim S, Masnon NA

BMJ Case Rep, 2021 May 12;14(5).

PMID: 33980562 DOI: 10.1136/bcr-2021-242082

We describe an uncommon cause of paraneoplastic optic neuropathy in adenocarcinoma of the lung. A 45-year-old healthy woman presented with seizure and encephalitis, followed by an acute visual loss in both eyes for 1 week. Her visual acuity was no perception of light in the right eye and hand movement in the left eye. There was a generalised restriction of extraocular muscle movements in both eyes. Funduscopy showed a bilateral pale optic disc. A paraneoplastic antigen autoimmune profile showed a positive anti-CV2/CRMP-5 antibody. CT of the thorax revealed the presence of right apical lung mass, confirmed to be adenocarcinoma through a biopsy. She was scheduled for lung lobectomy and chemotherapy. Unfortunately, her health deteriorated and she passed away eventually.

Matched MeSH terms: Middle Aged

Smartphone electrocardiogram for detecting atrial fibrillation after a cerebral ischaemic event: a multicentre randomized controlled trial

Koh KT, Law WC, Zaw WM, Foo DHP, Tan CT, Steven A, et al.

Europace, 2021 07 18;23(7):1016-1023.

PMID: 33782701 DOI: 10.1093/europace/euab036

AIMS: Atrial fibrillation (AF) is a preventable cause of ischaemic stroke but it is often undiagnosed and undertreated. The utility of smartphone electrocardiogram (ECG) for the detection of AF after ischaemic stroke is unknown. The aim of this study is to determine the diagnostic yield of 30-day smartphone ECG recording compared with 24-h Holter monitoring for detecting AF ≥30 s.

METHODS AND RESULTS: In this multicentre, open-label study, we randomly assigned 203 participants to undergo one additional 24-h Holter monitoring (control group, n = 98) vs. 30-day smartphone ECG monitoring (intervention group, n = 105) using KardiaMobile (AliveCor®, Mountain View, CA, USA). Major inclusion criteria included age ≥55 years old, without known AF, and ischaemic stroke or transient ischaemic attack (TIA) within the preceding 12 months. Baseline characteristics were similar between the two groups. The index event was ischaemic stroke in 88.5% in the intervention group and 88.8% in the control group (P = 0.852). AF lasting ≥30 s was detected in 10 of 105 patients in the intervention group and 2 of 98 patients in the control group (9.5% vs. 2.0%; absolute difference 7.5%; P = 0.024). The number needed to screen to detect one AF was 13. After the 30-day smartphone monitoring, there was a significantly higher proportion of patients on oral anticoagulation therapy at 3 months compared with baseline in the intervention group (9.5% vs. 0%, P = 0.002).

CONCLUSIONS: Among patients ≥55 years of age with a recent cryptogenic stroke or TIA, 30-day smartphone ECG recording significantly improved the detection of AF when compared with the standard repeat 24-h Holter monitoring.

Matched MeSH terms: Middle Aged

Fulltext Immunodeficiency and Thymoma: A Case Report on Good Syndrome, a Diagnosis Frequently Missed and Forgotten

Tang ASO, Loh WH, Wong QY, Yeo ST, Ng WL, Teoh PI, et al.

Am J Case Rep, 2021 Mar 13;22:e928659.

PMID: 33712551 DOI: 10.12659/AJCR.928659

BACKGROUND Good syndrome (thymoma with immunodeficiency) is a frequently missed and forgotten entity. It is a rare cause of combined B and T cell immunodeficiency in adults. To date, fewer than 200 patients with Good syndrome have been reported in the literature. CASE REPORT We report a case of type AB Masaoka-Koga stage I thymoma which predated the evidence of immune dysregulation by 5 years, manifesting as bilateral cytomegalovirus retinitis, multiple bouts of pneumonia, and bronchiectasis in a HIV-seronegative 55-year-old man. Intravitreal ganciclovir was administered in addition to intravenous systemic ganciclovir, which resulted in severe neutropenic sepsis. A thorough immunodeficiency workup confirmed the presence of hypogammaglobulinemia with complete absence of B cells and reduced CD4/CD8 ratio. The patient responded well to monthly intravenous immunoglobulin replacement therapy, with no further episodes of infection since then. The immunoglobulin level doubled after 1 year of treatment. However, as the patient refused further intravitreal and CMV-targeted treatment, his vision did not recover. CONCLUSIONS Clinicians should be aware that thymoma can precede the onset of immunodeficiency. Clinical suspicion should be heightened in at-risk patients who present with multiple bouts of infection, particularly in thymoma cases with adult-onset immune dysfunction. It is of paramount importance to follow up those patients with annual clinical reviews and immunodeficiency screening.

Matched MeSH terms: Middle Aged

A South Indian Cadaveric Study on the Prevalence of Gallstones

Satheesha NB, Soumya KV

Kathmandu Univ Med J (KUMJ), 2021 6 25;18(72):340-343.

PMID: 34165088

Background Gallstone disease (GSD) is one among the most prevalent diseases that affects approximately 10-15% of the population. It is associated with many other diseases like gallbladder cancer, renal stones, atherosclerosis, coronary heart disease and stroke. Objective Objective of this study is to document the prevalence of gallstones among south Indian cadavers. Method One hundred and twenty three South Indian cadaveric livers/gallbladders were observed for the presence of gallstones. The age range was 40 to 70 years. The gallbladders were palpated to know the presence of stones. They were then dissected and the stones were classified based on appearance. Gall bladder walls were also observed to know the associated fibrosis. Result Among the cadavers studied, 0.81% possessed cholesterol stones and 4.06% had pigment stones. Among the stones, 83.33% were pigment stones and 16.66% were cholesterol stones. Conclusion Compared to the western countries and north Indian studies, the prevalence of gallstone diseaseis low in the south Indian population (4.87%). The low prevalence was probably due to the low socioeconomic status and the diet and lifestyle.

Matched MeSH terms: Middle Aged

Fulltext Chikungunya virus-associated death in Malaysia

Sam IC, Kamarulzaman A, Ong GS, Veriah RS, Ponnampalavanar S, Chan YF, et al.

Trop Biomed, 2010 Aug;27(2):343-7.

PMID: 20962735

Chikungunya virus (CHIKV) is a mosquito-borne alphavirus which causes fever, rash, and arthralgia. In the past, life-threatening complications were very rarely reported. However, during the recent worldwide outbreaks, there have been several reports of unusually severe complications and deaths. Malaysia is experiencing a nationwide outbreak of CHIKV, with over 10 000 patients affected since April 2008. We report the first case of culture-confirmed CHIKV-associated death in Malaysia, in a patient with fever, rash, acute exacerbation of pre-existing heart failure, rhabdomyolysis, and multiple organ failure. CHIKV infections may cause atypical, severe or fatal presentations.

Matched MeSH terms: Middle Aged

Right Iliac Fossa Pain

Abu Hassan H, Suppiah S

Ann Acad Med Singap, 2016 Dec;45(12):567-568.

PMID: 28062887

Matched MeSH terms: Middle Aged

Pneumatosis intestinalis: a case report with a brief review of literature

Kutty MK, Nambiar B, Bau K

Med J Malaya, 1970 Mar;24(3):227-30.

PMID: 4246807

Matched MeSH terms: Middle Aged

Hyperosmolar nonketotic diabetic coma