Displaying publications 41 - 60 of 334 in total

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  1. Qi Qi C, Ajit Singh V
    BMJ Case Rep, 2012;2012.
    PMID: 22892228 DOI: 10.1136/bcr.01.2012.5518
    The authors present an interesting case under our follow-up who has had five different forms of tumours with different pathologies throughout his lifetime. He started off with hepatoma, followed by pleomorphic sarcoma of the thigh, adenocarcinoma of the prostate, meningioma and finally schwanoma. He is still alive to this date.
  2. Muniandy RK, Sinnathamby V
    BMJ Case Rep, 2012;2012.
    PMID: 22922924 DOI: 10.1136/bcr-2012-006562
    A 16-month-old child developed a brief generalised tonic-clonic fitting episode and vomiting at home, after accidental ingestion of traditional massage oil. As the patient presented with clinical features of salicylate toxicity, appropriate management was instituted. He was admitted to the intensive care unit for multiorgan support. The child was discharged well 1 week after the incident. Methyl-salicylate is a common component of massage oils which are used for topical treatment of joint and muscular pains. However, these massage oils may be toxic when taken orally. Early recognition of the salicylate toxicity is very important in producing a good patient outcome.
  3. Qi Qi C, Ajit Singh V
    BMJ Case Rep, 2012;2012.
    PMID: 22865804 DOI: 10.1136/bcr-2012-006401
    Marjolin's ulcers are malignancies that arise from previously traumatised, chronically inflamed or scarred skin. We present a case with childhood burns, who had repeated irritation of his forearm skin with palm oil thorns that eventually led to malignant change.
  4. Ibrahim SB, Yashodhara BM, Umakanth S, Kanagasabai S
    BMJ Case Rep, 2012;2012.
    PMID: 22744241 DOI: 10.1136/bcr.02.2012.5850
    A 23-year-old pregnant woman in her second trimester of pregnancy presented with blisters on the face, abdomen and the leg. Based on the clinical presentation and skin biopsy (histopathology and direct immunofluorescence) the diagnosis of pemphigus vulgaris was established. The child born to this patient also had similar skin lesions. The lesions in the mother and the child improved after treatment. The authors report a rare case of pemphigus vulgaris in a pregnant lady and neonatal pemphigus in her child, both of whom were treated successfully.
  5. Bastion ML, Mustapha M, Ho I
    BMJ Case Rep, 2012;2012.
    PMID: 23093508 DOI: 10.1136/bcr-2012-007260
    To report a unique case of crystallisation in the anterior chamber and subretinal space in a Malay lady following inadvertent subretinal injection of ranibizumab prior to vitrectomy for proliferative diabetic retinopathy.
  6. Bastion ML, Qader AM
    BMJ Case Rep, 2011;2011.
    PMID: 22696753 DOI: 10.1136/bcr.02.2011.3889
    The authors would like to present an unusual case of unilateral retinal detachment, phacodonesis, dense cataract and ocular coloboma in a 7-year-old Indian Muslim boy with Noonan syndrome. He underwent lensectomy, 23G pars planar vitrectomy, air fluid exchange, endolaser and silicone oil injection which successfully reattached the retina. His best corrected visual acuity was 6/24 6 months after the surgery and oil removal.
  7. Nimir AR, Ibrahim R, Ibrahim IA
    BMJ Case Rep, 2011;2011.
    PMID: 22689601 DOI: 10.1136/bcr.04.2011.4096
    The authors report a case of a 6-week-old baby girl who was admitted to the paediatric ward due to a high fever for 2 days. The patient experienced three fits which took place while in the ward. A brain sonogram showed subdural heterogeneous collection consistent with focal empyema; however, no hydrocephalus or infarction was detected. An urgent Burr hole procedure was performed to remove the collected pus. Both blood and cerebrospinal fluid (CSF) culture grew Salmonella species which remain sensitive to some antibiotics. This strain was sent to the institute of medical research (IMR) for serotyping. The patient was treated with intravenous combination of ceftriaxone and ciprofloxacin for 3 weeks. One week later, IMR sent results that identified the strain as Salmonella enterica serotype Houtenae. Following antibiotic treatment, repeat ultrasound illustrated an improvement of the subdural empyema, and the gram stain of the CSF specimen failed to isolate bacteria.
  8. Chew HB, Ngu LH, Keng WT
    BMJ Case Rep, 2011;2011.
    PMID: 22715259 DOI: 10.1136/bcr.02.2010.2706
    A rare syndrome of rapid-onset obesity with hypothalamic dysfunction, hypoventilation and autonomic dysregulation (ROHHAD) has been recently described. We report the first patient with this syndrome in Southeast Asia and review reported cases to date. Our patient was good health with normal development until the age of 2. He then developed hyperphagic obesity, hypersomnolence, seizures, alveolar hypoventilation, central hypothyroidism, sodium and water dysregulation, gastrointestinal dysmotility, strabismus, disordered temperature and irregular heart rate, altered sweating, delayed puberty, mental retardation and recurrent respiratory tract infections. The cardiomyopathy with heart failure and abnormal cerebral spinal fluid (CSF) neurotransmitter analysis present in our patient have not been reported previously. Tumours of the sympathetic nervous system are known to be associated with this syndrome but had not been found in our patient at the time of reporting. We highlight the difficulty of achieving the diagnosis of ROHHAD syndrome and its overlap with other well-established disease entities. The mortality and morbidity resulting from the high incidence of cardiorespiratory arrest may be prevented by early ventilatory support.
  9. Abdul Aziz DA, Khandasamy Y, Tamba RP, Zaki FM
    BMJ Case Rep, 2011;2011.
    PMID: 22679168 DOI: 10.1136/bcr.08.2011.4672
    The authors report a case of a 6-year-old girl who developed subacute intestinal obstruction after a trivial blunt trauma to her abdomen. Her normal vital signs masked the presence of intestinal bleeding. An incidental finding at surgery of a haematomatous polypoid vascular growth of the ileum was subsequently confirmed to be cavernous haemangioma of the small bowel. Surgical resection was curative in this patient.
  10. Rajalingham S, Said MS, Shaharir SS, AbAziz A, Periyasamy P, Anshar FM
    BMJ Case Rep, 2011;2011.
    PMID: 22675098 DOI: 10.1136/bcr.08.2011.4675
    Dermatomyositis is a rare rheumatic disease which predominantly affects the muscles and skin requiring a protracted course of immunosuppressants which may predispose the patients to opportunistic infections. A 49-year-old lady was diagnosed to have dermatomyositis in August 2010 based on history, significantly raised creatine kinase level and muscle biopsy findings. She had recurrent admissions due to fever, myalgia and muscle weakness. She had spiking temperature despite high dose steroids, broad-spectrum antibiotics and antifungal agents. This prompted extensive investigation which leads us to the additional diagnosis of disseminated tuberculosis involving the lungs, muscles and bones. This case demonstrates the challenge in controlling the disease activity of dermatomyositis with immunosuppressants in the setting of disseminated tuberculosis.
  11. Periyasamy P, Subramaniam SR, Rajalingham S
    BMJ Case Rep, 2011;2011.
    PMID: 22675021 DOI: 10.1136/bcr.09.2011.4816
    Data from the WHO state that up to 85% of cases of human schistosomiasis are from Africa. The common sites of this parasitic infection are the intestine and bladder. Testicular schistosomiasis is extremely rare but the number of reported cases worldwide has doubled over the past decade. The authors report a case of testicular schistosomiasis of a Myanmar immigrant in Malaysia who presented with a 6-month history of progressively enlarging left testicular swelling. His biochemical markers and cultures were not suggestive of an ongoing infection. Hence, a testicular malignancy was strongly suspected, for which, he underwent a left orchidectomy. Our clinical suspicion was proven wrong when the histopathology of the removed left testis revealed schistosomal eggs with granulamatous tissue formation. Subsequently, the patient was treated with praziquantel.
  12. Abdul Aziz DA, Abdul Rahman NA, Tang SF, Abdul Latif H, Zaki FM, Annuar ZM, et al.
    BMJ Case Rep, 2011;2011.
    PMID: 22674944 DOI: 10.1136/bcr.09.2011.4734
    Pulmonary Langerhans cell histiocytosis (LCH) in children is more extensive and is a rare cause of spontaneous secondary pneumothorax (SSP) which tends to be recurrent and refractory to conventional treatment. Its occurrence in paediatric patients posed great challenge to the choice of surgical management. Surgery in the form of pleurodesis is only considered if SSP does not improve after chemotherapy and after considering all relevant risk and benefits of surgery to patients. Chemical pleurodesis will not give the expected effect to eradicate SSP in this patient. Therefore mechanical pleurodesis is the treatment of choice. There are various techniques to perform mechanical pleurodesis; from pleural abrasion to pleurectomy. In the authors' experience, bilateral total pleurectomy provided the best outcome for this 9-year-old patient with persistent respiratory distress from SSP due to extensive pulmonary LCH.
  13. Bastion ML
    BMJ Case Rep, 2010;2010.
    PMID: 22242074 DOI: 10.1136/bcr.10.2009.2398
    The use of 0.5 mg/0.05 ml of ranibizumab intracamerally, to induce regression of iris neovascularisation in a non-diabetic patient, is reported. A 55-year-old Malay man presented with left eye rubeosis and hyphaema secondary to ischaemic remnant retinal flap in his silicone filled pseudophakic eye. Regression of rubeosis and resolution of hyphaema was noted within 4 days of injection of intracameral ranibizumab, allowing repeat vitrectomy to be performed without much bleeding, thus facilitating removal of his intraocular lens and laser to remaining flap. One month postoperatively he remained comfortable with counting fingers vision similar to the pre-hyphaema period.
  14. Hee LW, Singh VA, Jayalakshmi P
    BMJ Case Rep, 2010;2010.
    PMID: 22400059 DOI: 10.1136/bcr.09.2009.2266
    Gout is a disease where an abnormal collection of uric crystals (gouty tophi) can often be found in the foot and ankle. Occasionally such tophies are found at unusual sites and this can pose a challenge to the clinician where diagnosis and treatment is concerned. We describe a patient who presented to our oncology department with a swelling on his right thigh which was clinically diagnosed to be a soft tissue sarcoma, but after further investigations it turned out to be a gouty tophi. The purpose of this case report is to emphasise the variable presentation of gout and the challenges that can be faced by clinicians in diagnosing a soft tissue swelling.
  15. Peyman M, Ong MJ, Iqbal T, Subrayan V
    BMJ Case Rep, 2010;2010.
    PMID: 22802477 DOI: 10.1136/bcr.08.2010.3266
    Iris mammillations are dark brown, smooth, mound- or dome-shaped protuberances that are typically found on the anterior iris surface and are presumed to be congenital in origin. This congenital anomaly is usually unilateral and can be hereditary or sporadic. Lisch nodules in neurofibromatosis, tapioca melanoma of the iris, inflammatory iris granulomata and Cogan-Reese syndrome should be considered in the differential diagnosis. In this case report, the authors present a case of a bilateral iris mammillations in two siblings with congenital adrenal hyperplasia (CAH). To our knowledge, this is the first case where bilateral iris mammilations have been found to be associated with a systemic condition. Iris mammillations can be considered as one of the clinical signs in CAH in view of the pathogenesis discussed. Detailed ocular examination in CAH may reveal an increased incidence.
  16. Mahmod M, Nor IF, Maskon O
    BMJ Case Rep, 2010;2010.
    PMID: 22448190 DOI: 10.1136/bcr.02.2009.1549
    While selective non-steroidal anti-inflammatory drugs, namely cyclo-oxygenase-2 (COX 2) inhibitors, are known to be associated with acute myocardial infarction, little is known about the cardiovascular safety of the non-selective non-steroidal anti-inflammatory drugs. We report the case of a 44-year-old man who developed anaphylactic reaction and acute inferior myocardial infarction following ingestion of a non-selective anti-inflammatory drug, diclofenac sodium. Coronary angiography revealed a large thrombus in the right coronary artery which was partially removed by intracoronary catheter aspiration. Complete resolution of the remaining thrombus was achieved after treatment with an oral anticoagulant.
  17. Ngiu CS, Said MS, Periyasamy P, Low SF
    BMJ Case Rep, 2010;2010.
    PMID: 22778377 DOI: 10.1136/bcr.11.2009.2421
    Rituximab is a B-cell-depleting monoclonal anti-CD20 antibody. It is widely used in haematology and rheumatology. However, usage of rituximab in immunosupressed patient has been associated with various opportunistic infections. The authors reported a case of refractory rheumatoid arthritis treated with rituximab, which later presented with non-resolving pneumonia with pulmonary nodule. Percutaneous computer tomogram guided lung biopsy was arranged to confirm the suspicion of tuberculosis, but did not yield conclusive results. Later, she presented left-chest abscess and underwent incision and drainage. The pus culture and sensitivity confirmed pulmonary nocardiosis with chest wall dissemination. She was treated with 2-week course of trimethoprim sulfamethoxazole and responded. The authors also reviewed published cases of nocardiosis post-rituximab.
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