Displaying publications 41 - 60 of 84 in total

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  1. Jia, Ying Soo, Nur Ayub Mohd Ali, Aishath Azna Ali, Firdaus Hayati, Nornazirah Azizan, Andee Dzulkarnaen Zakaria, et al.
    MyJurnal
    Skeletal metastasis is a frequent complication of cancer resulting in significant morbidity as well as mortality. We highlight a case of a 73-year old gentleman with metastatic squamous cell carcinoma of the sternum. He denied dysphagia, shortness of breath, goitre, and presence of chronic non-healing ulcer. He was anaemic and carcinoembryonic antigen (CEA) was 18.7. Chest radiograph on lateral view showed a suspicious cortical irregularity. Computed tomography (CT) scan of thorax revealed an aggressive sternal lesion with soft tissue component. Ultrasound guided biopsy was performed and the biopsy was consistent with metastatic squamous cell carcinoma. Squamous cell carcinoma has a predilection to metastasize via haematogenous spread, but direct extension of tumour into the bone is not frequently seen. Finding the primary cause is utmost importance either via imaging modalities or invasive procedures. Isolated secondary lesion is extremely rare but unfortunate among defaulters. We discuss its diagnostic work-up and treatment options conserved to manage this condition.
    Matched MeSH terms: Goiter
  2. Hisham AN, Sarojah A, Alvin A
    Med J Malaysia, 2001 Dec;56(4):500-2.
    PMID: 12014772
    A case of non-recurrent laryngeal nerve is reported. The non-recurrent laryngeal nerve was found on the right side and was not associated with any vascular abnormalities. The anatomy and surgical implication of this rare condition is discussed
    Matched MeSH terms: Goiter, Nodular/pathology; Goiter, Nodular/surgery*
  3. Ali O, Isa ZM
    Asia Pac J Clin Nutr, 1995 Sep;4(3):319-24.
    PMID: 24394359
    This study was conducted to investigate the nutritional status of the rural population in Malaysia, especially women and children. A total of 262 women aged 18 and over and 183 children aged 2-6 years were selected using multistage cluster sampling from four locations in rural areas. It was found that the prevalence of malnutrition among children 2-6 years old ranged between 25.5% in the Malays Felda settlement scheme to 80% in the Orang Asli settlement. Malnutrition was associated with worm infestations, bottle feeding and early weaning. More than 30% of Orang Asli women were malnourished compared to less than 15% of Malay Felda settlement women. On the other hand, Malay women in the land settlement scheme had a higher risk of developing overweight and diabetes. Goitre was found among 11.5% of children; however, no cretinism was found. Breast feeding was still a common practice among rural mothers, but inadequate health education tended to reduce the duration of breast feeding and increased early weaning. Upgrading women's status in the rural areas will ultimately improve the nutritional and health status of the children and community as a whole.
    Matched MeSH terms: Goiter
  4. Loo GH, Wan Mat WR, Muhammad R, Azman M
    BMJ Case Rep, 2019 Aug 04;12(8).
    PMID: 31383679 DOI: 10.1136/bcr-2019-229763
    Acute airway obstruction in pregnancy remains a challenge to manage. Failure of appropriate and timely airway management may lead to maternal morbidity and mortality such as aspiration pneumonitis or worst hypoxaemic cardiopulmonary arrest. 1 As pregnancy may exacerbate asthma attacks, parturient presenting with wheezing or shortness of breath will commonly be treated as suffering from an asthmatic attack. 2 However, it is important to note other possible differential diagnoses. Thyroid disease is relatively common in women of childbearing age. The thyroid gland undergoes several changes during pregnancy, which may lead to altered function as well as gland enlargement and cause upper airway obstruction and symptoms similar to a bronchial asthma attack. 3 4 With that in mind, we report a case of a parturient with long-standing goitre in her second trimester who presented to our institution with acute respiratory symptoms and cardiopulmonary arrest.
    Matched MeSH terms: Goiter, Substernal/complications; Goiter, Substernal/diagnosis*
  5. Ikhwan, S.M., Irfan, M., Nazli, M.Z.M., Hassan, S., Rahman, M.N.G.
    MyJurnal
    Thyroid enlargement is one of the common surgical presentations in the Department of Surgery, Hospital Universiti Sains Malaysia (HUSM). Among them, benign non-toxic multinodular goiter constitutes one third (30%) of patients who underwent thyroidectomy. Common complications of thyroidectomy include recurrent laryngeal nerve (RLN) injury, hypocalcaemia, and recurrence of the thyroid lesion. Objective & Methods: This is a retrospective study of patients diagnosed with multinodular goiter treated in HUSM between January 1996 and December 2005. A total of 111 patients were studied and 52 of them underwent subtotal thyroidectomy while 59 underwent total thyroidectomy. The outcome in terms of RLN injury, hypocalcaemia and mass recurrence were analyzed. Results: Post operative complications were studied in both groups. Permanent recurrent laryngeal nerve injury occurs in 2.4% (1 case) in subtotal thyroidectomy group compared to total thyroidectomy group (3.6%, 2 cases). Five cases from total thyroidectomy group suffered from permanent hypocalcaemia but none in the other group. 70.7% (29 cases) from subtotal thyroidectomy group have functional remnant of thyroid tissue. Recurrence rate post subtotal thyroidectomy after 5 years is only 4.9% (2 cases). Conclusion: The post operative outcome in patients who underwent subtotal thyroidectomy in HUSM from January 1996 to
    December 2005 was better than total thyroidectomy with significant functional thyroid remnant.
    Matched MeSH terms: Goiter, Nodular
  6. Abdullah MI, Junit SM, Ng KL, Jayapalan JJ, Karikalan B, Hashim OH
    Int J Med Sci, 2019;16(3):450-460.
    PMID: 30911279 DOI: 10.7150/ijms.29935
    Papillary thyroid cancer (PTC) is the most prevalent form of malignancy among all cancers of the thyroid. It is also one of the few cancers with a rapidly increasing incidence. PTC is usually contained within the thyroid gland and generally biologically indolent. Prognosis of the cancer is excellent, with less than 2% mortality at 5 years. However, more than 25% of patients with PTC developed a recurrence during a long term follow-up. The present article provides an updated condensed overview of PTC, which focuses mainly on the molecular alterations involved and recent biomarker investigations.
    Matched MeSH terms: Goiter, Nodular/complications
  7. Noran, H., Zulkifli, A., Naing, L., Mafauzy, M.
    MyJurnal
    Iodine is an essential micronutrient for normal physical and mental development. Iodine deficiency is endemic in 130 countries worldwide, including Malaysia. This is a cross-sectional study done to determine the prevalence and risk factors of iodine dejiciency among 342 rural mothers attending antenatal clinics in Bachok, Kelantan. A self-adrninistered questionnaire on the knowledge, attitudes, practices and other risk factors relating to iodine deficiency was done. Physical examination for thyroid enlargement was carried out and urine samples were taken for urine iodine determination. The prevalence of iodine deficiency based on urine iodine Q level of less than 100 mcg/l was 63.0 % (95% CI: 57.8, 68.2). The mean urinary iodine level was 87.3 mcg/l with a median of 78.0 mcg/l. However, the goiter prevalence was only 9.4%. The total mean scores of knowledge, attitudes and practices were generally low at 58.6 (SD 7.9), 52.9 (SD 7.9) and 42.9 (SD 10.9) respectively. Logistic regression analysis found that a smoking husband is a risk for iodine deficiency (OR=2.0). In conclusion, iodine deficiency disorders among rural antenatal mothers were still prevalent in Bachok. Their level of knowledge on the causes, effects, prevention and clinical presentations of Q iodine deficiency disorders were poor. In addition, having a husband who is a smoker increases the risk of the antenatal mothers developing iodine denciency.
    Study site: Antenatal clinic (klinik kesihatan), Bachok, Kelantan, Malaysia
    Matched MeSH terms: Goiter
  8. Lee CC, Harun F, Jalaludin MY, Heh CH, Othman R, Junit SM
    BMJ Open, 2015 Jan 05;5(1):e006121.
    PMID: 25564141 DOI: 10.1136/bmjopen-2014-006121
    OBJECTIVES: The c.2268dup mutation in the thyroid peroxidase (TPO) gene is the most common TPO alteration reported in Taiwanese patients with thyroid dyshormonogenesis. The ancestors of these patients are believed to originate from the southern province of China. Our previous study showed that this mutation leads to reduced abundance of the TPO protein and loss of TPO enzyme activity in a Malaysian-Chinese family with goitrous hypothyroidism. The aim of our study was to provide further data on the incidence of the c.2268dup mutation in a cohort of Malaysian-Chinese and its possible phenotypic effects.

    SETTING: Cohort study.

    PARTICIPANTS: Twelve biologically unrelated Malaysian-Chinese patients with congenital hypothyroidism were recruited in this study. All patients showed high thyrotropin and low free thyroxine levels at the time of diagnosis with proven presence of a thyroid gland.

    PRIMARY OUTCOME MEASURE: Screening of the c.2268dup mutation in the TPO gene in all patients was carried out using a PCR-direct DNA sequencing method.

    SECONDARY OUTCOME MEASURE: Further screening for mutations in other exonic regions of the TPO gene was carried out if the patient was a carrier of the c.2268dup mutation.

    RESULTS: The c.2268dup mutation was detected in 4 of the 12 patients. Apart from the c.2268dup and a previously documented mutation (c.2647C>T), two novel TPO alterations, c.670_672del and c.1186C>T, were also detected in our patients. In silico analyses predicted that the novel alterations affect the structure/function of the TPO protein.

    CONCLUSIONS: The c.2268dup mutation was detected in approximately one-third of the Malaysian-Chinese patients with thyroid dyshormonogenesis. The detection of the novel c.670_672del and c.1186C>T alterations expand the mutation spectrum of TPO associated with thyroid dyshormonogenesis.

    Matched MeSH terms: Goiter/enzymology; Goiter/genetics*
  9. Kamath R, Bhat V, Rao R, Das A, Ks G, Kamath A
    Indian J Community Med, 2009 Jan;34(1):48-51.
    PMID: 19876455 DOI: 10.4103/0970-0218.45373
    BACKGROUND: To determine the prevalence of goiter and to study the factors influencing goiter among people of the rural community in Karnataka state, a community based study. Setting and Study Design: A cross sectional study was carried out to find out the prevalence of goiter in a rural community of Belgaum district. The study was conducted by house-to-house survey for a period of one month.
    MATERIALS AND METHODS: Two villages (Handiganur and Gundwad) were selected randomly from Belgaum and Raibag taluks of Belgaum district. All the family members in each household were examined for the presence of goiter using WHO criteria. Iodine content of the salt sample obtained from each household was estimated by using spot testing kits. Information regarding the determinants of goiter was collected and recorded in a pre tested proforma. Data collected was analyzed using SPSS statistical packages.
    RESULTS: The prevalence of goiter among rural population was found to be 16.6%. Goiter of grade 1 was 15.7% and that of grade 2 was 0.9%. Prevalence among males and females were 7.2% and 21.8%, respectively. The prevalence of goiter was highest among adolescents. Estimation of iodine content in the salt sample revealed that 50% of samples had adequate iodine content (>/=15 ppm). Multiple Logistic Regression Analysis revealed that females of the age group 10-49 years were independently associated with goiter.
    CONCLUSION: Prevalence of goiter was relatively high and therefore constituted a public health problem in this region.
    KEYWORDS: Determinants; goiter; multiple logistic regression analysis; prevalence
    Matched MeSH terms: Goiter
  10. Zaleha M.I., Osman A., Iskandar Z.A., Zainuddin B., Mohd. Ali M., Khalid B.A.K.
    Sains Malaysiana, 1996;25(2):51-58.
    Goitre prevalence and mental performance were determined amongst the Aborigines in Sinderut, a remote rural area in Pahang. A total of 196 subjects aged 4 to 60 years old were selected for study. Goitre status was determined by an experienced endocrinologist using classification suggested by World Health Organization; while mental performance was measured using Raven's test (Oxford Psychologists Press). Blood specimen was also taken for thyroxine (T4) and thyroid stimulating hormone (TSH) measurement. It was found that goitre prevalence was 26.5% (52/196); with visible goitre prevalence of 42.3% (22152). The overall mean of goitre volume was 21.4 ± 19.1 ml (range: 3.0 - 90.8 ml), while the prevalence of mental performance for the percentile value of more than 5.0 was 26.5% (range: 5.0 - 50.0). Mean thyroxine levels was 75.4 ± 19.3 nmol/L (range: 19.9 - 138.1 nmol/ L) while mean levels of thyroid stimulating hormone was 4.9 ± 3.2 mU/L (range: 0.4 - 18.9 mU/L). There was no significant correlation between hormone levels and mental performance score (Pearson Correlation; T4 : r=-0.002, p=0.9736; TSH : r=0.10, p=0.1843). goitre volume and mental performance score (Pearson Correlation; r=-0.02, p=0.8395). Goitre prevalence of more than 20% in this area indicates a moderate endemia, while mental performance showed a low thinking level in the Aborigines particularly those who lived in remote areas.
    Matched MeSH terms: Goiter*
  11. Hisham AN, Sarojah A, Mastura T, Lim TO
    Asian J Surg, 2004 Jul;27(3):172-5.
    PMID: 15564155
    Measurement of prevertebral soft tissue is commonly used to assess prevertebral abnormalities, such as retropharyngeal abscess or injury to the cervical spine. In the presence of goitres, the widened prevertebral tissue seen on plain lateral neck radiograph may be diagnostic of an enlarged tubercle of Zuckerkandl (ZT), which may be responsible for most pressure symptoms. The aim of this study was to substantiate the value of plain lateral neck radiographs in preoperative demonstration of enlarged ZT.
    Matched MeSH terms: Goiter/radiography*
  12. Osman A, Khalid BAK, Tan TT, Wu LL, Ng ML
    Asia Pac J Clin Nutr, 1992 Mar;1(1):13-20.
    PMID: 24323000
    The relationship between malnutrition, goitre and thyroid hormones was studied among Aborigines and Malays in Ulu Langat, Malaysia. Fifty Aborigines aged >=7years were selected randomly for anthropometric, clinical and hormonal assessment. Fifty Malays of similar age from the nearby Malay village were chosen as controls. The Aborigines had a higher prevalence of malnutrition and goitre compared to the Malays. The prevalence of goitre was 26.5% amongst Aborigines and 19.6% among the Malays. All the nutritional indexes measured were significantly different between the two communities, especially among females. The differences corresponded to significant differences in levels of thyroid-stimulating hormone (TSH) measured using a highly sensitive TSH assay. By univariate analysis the increase in TSH corresponded to the decrease in body mass index (BMI). On the other hand, no association was found between BMI and goitres. No thyroid autoantibodies were detected and all subjects were clinically euthyroid and had normal thyroxine and triidothyronine levels. However, consumption of cassava conferred a four-fold risk of developing goitres. The high prevalence of goitres in malnourished subjects in this region which is not known to be iodine deficient could be due to cassava consumption.
    Matched MeSH terms: Goiter*
  13. Sakinah SO, Khalid BA, Aishah AB
    Ann Acad Med Singap, 1993 Jul;22(4):563-6.
    PMID: 8257059
    A study to determine the prevalence of goitre and abnormal thyroid status during pregnancy in Malaysian women was conducted. Two hundred and three women (Malay = 85, Chinese = 47 and Indian = 71) in the third trimester and with no known thyroid disease were studied. There was a marked racial disparity in the prevalence of goitre: Indian 61%, Malay 28% and Chinese 29% (p = 0.001). The serum thyrotropic hormone (TSH) was significantly higher in Indians (median: 1.36 uIU/ml) compared to Malays (1.14 uIU/ml, p = 0.009). The serum albumin was also significantly lower in Indians (mean +/- sd; 36.12 +/- 3.9 mmol/l) compared to Malays (39.3 +/- 4.8 mmol/l) or Chinese (39.1 +/- 5.2) (p < 0.001). Thyroid antibody was detected in 14.6% of these women with no significant racial difference in its prevalence. Three women were found to be thyrotoxic but none were hypothyroid. This study found a high prevalence of goitre among the pregnant Indian women, probably related to the protein malnutrition state. The high prevalence of positive thyroid antibody in our population indicates that a high percentage of women are at risk of developing postpartum thyroiditis.
    Matched MeSH terms: Goiter, Endemic/blood; Goiter, Endemic/diagnosis; Goiter, Endemic/epidemiology
  14. Lum SK
    Med J Malaysia, 2013 Oct;68(5):439-40.
    PMID: 24632876 MyJurnal
    A patient is said to have subclinical hyperthyroidism if he has a depressed thyroid stimulating hormone (TSH) level but is clinically euthyroid and has a normal thyroxine (T4) and triiodothyronine (T3) level. The aetiology of this condition is unknown, its progression is uncertain and the value of treatment is doubtful. These 2 cases show a rapid reversal of TSH suppression within a week after thyroidectomy. This suggest an unidentified potent but innocuous suppressor of TSH is produced by some large nodular goitres. Patients with multinodular goitres with subclinical hyperthyroidism can have their anxiety allayed with assurance that their condition is benign and that their TSH suppression is due to the presence of an innocuous substance which is protective in nature. This substance, when isolated, will find a useful place in the prevention and treatment of papillary carcinoma of the thyroid because of its potent effect on the pituitary-thyroid axis without causing any peripheral effects.
    Matched MeSH terms: Goiter, Nodular
  15. Tun M, Salekan K, Sain AH
    Malays J Med Sci, 2003 Jan;10(1):86-9.
    PMID: 23365506 MyJurnal
    From 1996 to 2001, 393 thyroidectomies were performed and 25 (6.4%) patients underwent reoperative thyroid surgery at Hospital Universiti Sains Malaysia. All reoperated patients had undergone one prior thyroid operation. All were females with an average age of 39.1 years (18-61 years). The most frequent indication for reoperation was cancer in resected specimen of an originally misdiagnosed carcinoma treated by partial thyroid resection. Final histological diagnosis of 25 reoperations showed thyroid carcinoma in 22 (88%) cases and multinodular goiter in 3 cases. The overall interval between the initial and the reoperative procedures ranged from 3 weeks to 15 years. There was no post-operative mortality after reoperation. Post-operative complications were discovered in 5 patients, as 3 (12%) of whom had transient hypocalcaemia, one (4%) had wound breakdown and one (4%) had permanent recurrent laryngeal nerve palsy. Reoperative thyroid surgery is an uncommon operation with high complication rate.
    Matched MeSH terms: Goiter
  16. Vengathajalam S, Retinasekharan S, Mat Lazim N, Abdullah B
    Indian J Otolaryngol Head Neck Surg, 2019 Oct;71(Suppl 1):823-826.
    PMID: 31742073 DOI: 10.1007/s12070-019-01654-6
    Thyroid abscesses are the most rare conditions of the thyroid gland but it could be potentially life threatening. Most patients are immunocompromised or has an underlying chronic thyroid disorder. We report a case of a 58 year-old lady with underlying uncontrolled diabetes mellitus and a long standing uninvestigated goiter who presented with lethargy, a new anterior neck swelling with dysphagia and change of voice. Ultrasound and computed tomography were performed and showed collection with multiple air pockets in the right thyroid lobule extending to the anterior mediastinum. She was started on intravenous antibiotics and underwent serial bedside aspiration. Her symptoms improved and complete resolution was achieved after serial aspirations and antibiotics.
    Matched MeSH terms: Goiter
  17. Khoo KS, Koh PS, Ng KL
    Gland Surg, 2020 Dec;9(6):2198-2203.
    PMID: 33447571 DOI: 10.21037/gs-20-474
    Acute suppurative thyroiditis account for <1% of thyroid diseases and is uncommon because of the gland's encapsulation, iodine-rich environment, good vascular supply and extensive lymphatic drainage. It has been reported in patients with underlying goiters, thyroid cancers and in immuno-compromised patients. The usual causative organisms are Staphylococci spp. and Streptococci spp. Rarer organisms include Klebsiella spp. and Salmonella spp. Due to its rarity (as there have been only 28 cases of Salmonella thyroid abscess being reported in the literature till 2020), only case reports are available to guide management. We report two cases of thyroid abscess due to Salmonella enteritidis in our institution that may herald the re-emergence of this uncommon infection of the thyroid gland and to raise awareness for all clinicians. Both patients presented with neck swelling, dysphagia and sepsis. Surgical intervention was warranted in both patients due to the severity of the disease and failed medical therapy. Recovery was uneventful following adequate surgical intervention and antibiotic therapy according to the culture and sensitivity report of the pathogen. This case report highlights that both patients were immunocompromised, and they contracted Salmonella thyroid abscess without any gastrointestinal involvement. Thus, a high index of suspicion for Salmonella thyroid abscess in immunocompromised patients can expedite the diagnosis and appropriate management can be commenced such as antibiotic therapy, percutaneous aspiration and surgical drainage in the event of failed medical therapy.
    Matched MeSH terms: Goiter
  18. Foo LC, Zainab T, Nafikudin M, Letchuman GR
    Ann Endocrinol (Paris), 1996;57(6):470-5.
    PMID: 9084692
    The urinary iodine excretions of women (15-40 y) and young children (< or = 6 y) from two longhouse villages in the iodine-deficient district of Lubok Antu, Sarawak, were compared. One longhouse (Mengkak) was provided with freshly produced iodized salt every two months (one kg per family) while the other (Menjiling) was provided with iodized water via fortification of the village piped-water supply. Spot urines were collected for iodine determination at baseline and at 6 and 12 months after the start of the study. Salt and water samples were collected at monthly intervals. Goiter assessment was performed on the women at the start and end of the one-year study. The mean iodine concentrations in the salt samples from Mengkak and Menjiling were, respectively, 47.1 +/- 9.7 mg/kg (n = 60) and 0.8 +/- 3.4 mg/kg (n = 60) while the mean iodine concentration in the water samples from Menjiling was 138.6 +/- 43.2 micrograms/L (n = 24); iodine could not be detected in the water samples from Mengkak. There were significant and sustained increases in median urinary iodine excretions of both women and young children in Menjiling; in Mengkak, however, significant and sustained increases in median urinary iodine excretions were observed only in women while the median urinary iodine excretions of children remained essentially unchanged throughout the study period. Goiter prevalences in the women were reduced in both longhouses. The above observations reveal the inadequacy of iodized salt as a vehicle for iodine delivery to young rural Sarawakian children and indicate the need for other means of delivering supplemental iodine to this age group in areas where salt iodization is the only strategy for IDD control. In contrast, iodization of village water supply by itself is adequate in delivering iodine uniformly to the whole community.
    Matched MeSH terms: Goiter/epidemiology
  19. Ogihara T, Yamamoto T, Fukuchi M, Oki K
    J Clin Endocrinol Metab, 1972 Nov;35(5):711-5.
    PMID: 5071341
    Matched MeSH terms: Goiter, Endemic/blood*; Goiter, Endemic/etiology; Goiter, Endemic/epidemiology
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