MyMedR

Detection of β-globin Gene Mutations Among β-thalassaemia Carriers and Patients in Malaysia: Application of Multiplex Amplification Refractory Mutation System-Polymerase Chain Reaction

Hassan S, Ahmad R, Zakaria Z, Zulkafli Z, Abdullah WZ

Malays J Med Sci, 2013 Jan;20(1):13-20.

PMID: 23613656

β-thalassaemia is one of the most common single-gene disorders worldwide. Each ethnic population has its own common mutations, accounting for the majority of cases, with a small number of mutations for the rarer alleles. Due to the heterogeneity of β-thalassaemia and the multi-ethnicity of Malaysians, molecular diagnostics may be expensive and time consuming.

Fulltext Infant with a sudden, large, post-extubation subglottic cyst

Asha'ari ZA, Suhaimi Y, Fadzil A, Zihni M

Malays J Med Sci, 2012 Oct;19(4):84-7.

PMID: 23613654 MyJurnal

Acquired subglottic cyst in infancy is almost always associated with episodes of early life intubation. Most cases typically presented late, usually days to months after extubation. We report a case of a subglottic cyst with different presentation than the norm. This case highlights that subglottic cyst can present acutely, and rapidly enlarging soon after the airway extubation. As the management of a large subglottic cyst can be challenging, a close observation for early diagnosis and intervention are recommended post extubation in the high-risk cases, such as in the premature infant.

Fulltext Penile augmentation with resultant foreign material granuloma and sequalae

Inn FX, Imran FH, Ali MF, Ih R, Z Z

Malays J Med Sci, 2012 Oct;19(4):81-3.

PMID: 23613653 MyJurnal

Throughout history, a proportion of men appear to correlate penis size and dimensions directly with physical fitness and sexual prowess. Foreign materials, such as paraffin oil, paraffin balm, mineral oils, and silicone, have been used to promise an improvement in penile shaft contour and dimensions. These materials are injected directly into the penis; inducing granuloma formation to achieve increased penis length and girth. However, the result is a severely disfigured and swollen penis, which cannot achieve erection. Local complications of penile lipogranuloma include infection, ulceration, local migration, and cavernosal invasion; leading to functional impairment. Meanwhile, systemic complications include foreign body embolization, organ infarct, and death. Penile lipogranuloma is best treated surgically. Granulomatous skin needs to be completely excised; wound closure with a scrotal skin flap, Cecil's inlay operation and split thickness skin graft commonly used options. Our case series has shown that penile lipogranuloma, induced by subcutaneous foreign body injections into the penile shaft, and its subsequent adverse outcomes to patients and their partners.

Spontaneous Reversibility of an Iatrogenic Orthodontic Elastic Band-induced Localized Periodontitis Following Surgical Intervention - Case Report

Nettem S, Kumar Nettemu S, Kumar K, Reddy V, Siva Kumar P

Malays J Med Sci, 2012 Oct;19(4):77-80.

PMID: 23613652

Orthodontic elastic bands are an important iatrogenic etiologic factor in the causation of periodontal attachment apparatus breakdown. Appropriate diagnosis and a well constructed treatment plan tailor-made to suit the requirements of the particular patient is imperative for management of periodontal lesions induced by subgingival retention of rubber band. There are conflicting reports regarding the reattachment and regeneration of lost periodontal supporting tissues in such cases. The present case report highlights the spontaneous reversal and correction of periodontal destruction due to iatrogenic orthodontic elastic band displacement deep into the subgingival tissues.

Fulltext Hodgkin lymphoma mimicking a large soft tissue sarcoma of the shoulder: the essential role of immunohistochemistry in histopathological diagnosis

Zainal Abidin I, Zulkarnaen AN, Dk Norlida AO, Wai Hoong C, Huong Ling L

Malays J Med Sci, 2012 Oct;19(4):72-6.

PMID: 23613651 MyJurnal

The shoulder and axillary regions contain various complex anatomical structures in close proximity, many of which can give rise to neoplasms. Determining the origin and hence the exact diagnosis of advanced (diffuse) tumours in this region may become problematic. In view of the tumour morphology and the affected location in this case, we highlighted the importance of Hodgkin lymphoma immunohistochemistry interpretation in a tumour which was initially suspected to be a soft tissue sarcoma.

Fulltext Gastric duplication cyst in an infant presenting with non-bilious vomiting

G KK

Malays J Med Sci, 2012 Jan;19(1):76-8.

PMID: 22977380 MyJurnal

In an infant presenting with a mass in the abdomen and non-bilious vomiting, duplication cyst needs to be considered in the list of differential diagnoses. Gastric duplication cyst is an uncommon occurrence in children. Diagnosis is based on clinical findings and imaging features. Surgical excision is safe and offers a complete cure. The literature recommends excision even in asymptomatic cases due to isolated reports of malignancy arising in the duplication cyst in later life.

Fulltext Two different surgical approaches for strangulated obturator hernias

Sze Li S, Kenneth Kher Ti V

Malays J Med Sci, 2012 Jan;19(1):69-72.

PMID: 22977378 MyJurnal

Obturator hernia is a rare condition that may present in an acute or subacute setting in correlation with the degree of small-bowel obstruction. Pre-operative diagnosis is difficult, as symptoms are often non-specific. A high index of suspicion should be maintained for emaciated elderly women with small-bowel obstruction without a previous abdominal operation and a positive Howship-Romberg sign. When diagnosis is in doubt, computed tomography scan of the abdomen and the pelvis (if available) or laparotomy should be performed immediately, as high mortality rate is related to the perforation of gangrenous bowels. We present 2 cases of strangulated obturator hernia, managed differently with both open and laparoscopic approaches. The diagnostic accuracy of computed tomography scan is highlighted followed by a brief literature review with an emphasis placed on surgical management.

Fulltext Pheochromocytoma and pregnancy: a difficult and dangerous ordeal

Mohamed Ismail NA, Abd Rahman R, Abd Wahab N, Muhammad R, Nor Azmi K

Malays J Med Sci, 2012 Jan;19(1):65-8.

PMID: 22977377 MyJurnal

Pheochromocytoma during pregnancy is potentially disastrous to the mother and fetus. Its ambiguous presentation is often mistaken for pre-eclampsia, although it may imitate other problems during pregnancy. Early diagnosis and timely, appropriate management reduces possible maternal and fetal complications. We identified a case of pheochromocytoma during pregnancy; the condition was initially diagnosed as pre-eclampsia complicated with gestational diabetes. Surgical intervention via left adrenalectomy was successfully performed in the second trimester. After surgery, all of the patient's medical problems nearly subsided and she did not require further treatment. However, her fetus displayed restricted intrauterine growth, and the patient eventually had premature delivery via a caesarean section. A multidisciplinary team to identify and treat pheochromocytoma is mandatory to ensure optimal conditions for tumour removal and to anticipate any possible catastrophic events.

Fulltext Comparison of Image Quality Criteria between Digital Storage Phosphor Plate in Mammography and Full-Field Digital Mammography in the Detection of Breast Cancer

Thevi Rajendran P, Krishnapillai V, Tamanang S, Kumari Chelliah K

Malays J Med Sci, 2012 Jan;19(1):52-9.

PMID: 22977375 MyJurnal

Digital mammography is slowly replacing screen film mammography. In digital mammography, 2 methods are available in acquiring images: digital storage phosphor plate and full-field digital mammography. The aim of this study was to compare the image quality acquired from the 2 methods of digital mammography in the detection of breast cancer.

Fulltext Association of the Cocaine- and Amphetamine-Regulated Transcript Prepropeptide Gene (CARTPT) rs2239670 Variant with Obesity among Kampar Health Clinic Patrons, Malaysia

Yeo L, Fan SH, Say YH

Malays J Med Sci, 2012 Jan;19(1):43-51.

PMID: 22977374 MyJurnal

BACKGROUND: Cocaine- and amphetamine-regulated transcript (CART) is a hypothalamic anorectic neuropeptide that controls feeding behaviour and body weight. The study objective was to investigate the association of the CART prepropeptide gene (CARTPT) rs2239670 variant with obesity and its related anthropometric indicators among patients of a Malaysian health clinic in Kampar, Perak, Malaysia.
METHODS: A total of 300 Malay/Peninsular Bumiputera, Chinese, and Indian subjects (115 males, 185 females; 163 non-obese, 137 obese) were recruited by convenience sampling, and anthropometric measurements, blood pressures, and pulse rate were taken. Genotyping was performed using AvaII polymerase chain reaction-restriction fragment length polymorphism.
RESULTS: Genotyping revealed 203 (67.7%), 90 (30.0%), and 7 (2.3%) subjects with the GG, GA, and AA genotypes, respectively, with a minor allele (A) frequency of 0.17. No significant difference in the CARTPT rs2239670 genotype and allele distribution was found between obese and non-obese subjects, and logistic regression showed no association between the mutated genotypes (GA, AA) and allele (A) with obesity, even after adjusting for age, gender, and ethnicity. Furthermore, the measurements did not differ significantly between the genotypes and alleles. No significant difference in the genotype and allele distribution was found among genders, but they were significantly different among ethnicities (P = 0.030 and P = 0.019, respectively).
CONCLUSION: CARTPT rs2239670 is not a predictor for obesity among the Malaysian subjects in this study.
KEYWORDS: Malaysia; anthropometry; cocaine- and amphetamine-regulated transcript protein; genetic association study; obesity; single nucleotide polymorphism

Effect of repeatedly heated palm olein on blood pressure-regulating enzymes activity and lipid peroxidation in rats

Leong XF, Salimon J, Mustafa MR, Jaarin K

Malays J Med Sci, 2012 Jan;19(1):20-9.

PMID: 22977371

BACKGROUND: Oxidative stress is associated with the pathogenesis of cardiovascular diseases. The process of deep-fat frying in dietary cooking oil plays a role in the generation of free radicals. In this study, palm olein heated to 180 °C was tested for its effect on the activity of blood pressure-regulating enzymes and lipid peroxidation.

METHODS: Forty-two adult male Sprague-Dawley rats were equally assigned into 6 groups.The first group was fed with normal rat chow as the control group, and the subsequent groups were fed with rat chow fortified with 15% weight/weight of the following: fresh palm olein, palm olein heated once, palm olein heated twice, palm olein heated 5 times, or palm olein heated 10 times. The duration of feeding was 6 months. Fatty acid analyses of oil were performed using gas chromatography. Peroxide values were determined using standard titration. Plasma was collected for biochemical analyses.

RESULTS: Repeatedly heated palm olein increased the levels of peroxide, angiotensin-converting enzyme, and lipid peroxidation as well as reduced the level of heme oxygenase. Fresh palm olein and palm olein heated once had lesser effects on lipid peroxidation and a better effect on the activity of blood pressure-regulating enzymes than repeatedly heated palm olein.

CONCLUSION: Repeatedly heated palm olein may negatively affect the activity of blood pressure-regulating enzymes and increase lipid peroxidation.

Fulltext The impact of nutrition education interventions on the dietary habits of college students in developed nations: a brief review

Lua PL, Wan Putri Elena WD

Malays J Med Sci, 2012 Jan;19(1):4-14.

PMID: 22977369 MyJurnal

The purpose of this review is to provide a summary of studies on the effectiveness nutrition education interventions used by college students. Electronic databases such as Medline, Science Direct, CINAHL (EBSCOhost), and Google Scholar were explored for articles that involved nutrition education interventions for college students and that were published between 1990 and 2011. Fourteen studies, which involved a total of 1668 college students as respondents, were identified and met the inclusion criteria. The results showed that there were 3 major forms of nutrition education interventions: web-based education, lectures, and supplement provisions. Dietary intake measures were used in almost all studies and were primarily collected with food records, recall, food frequency questionnaires, and dietary habit questionnaires. The outcome measures varied among the studies, with indicators such as consumption of food, nutrition knowledge, dietary habits, physical activity, and quality of life. Methodological issues were also identified. In general, college students experienced significant changes in their dietary habits after the interventions were employed. The highlighted methodological issues should be considered to improve the quality of similar research in future.

Fulltext Acute lower gastrointestinal haemorrhage secondary to small bowel ascariasis

Stephen DD, Siow SL

Malays J Med Sci, 2012 Apr;19(2):92-5.

PMID: 22973144 MyJurnal

Acute lower gastrointestinal haemorrhage secondary to small bowel ascariasis is extremely rare. A high level of suspicion should be maintained when dealing with acute gastrointestinal haemorrhage in migrants and travellers. Small bowel examination is warranted when carefully repeated upper and lower endoscopies have failed to elicit the source of bleeding. Appropriate test selection is determined by the availability of local expertise. We present a case of acute lower gastrointestinal haemorrhage secondary to jejunal ascariasis and a literature search on lower gastrointestinal haemorrhage associated with jejunal infestation with Ascaris.

Fulltext Breast carcinoma occurring from chronic granulomatous mastitis

Mazlan L, Suhaimi SN, Jasmin SJ, Latar NH, Adzman S, Muhammad R

Malays J Med Sci, 2012 Apr;19(2):82-5.

PMID: 22973142 MyJurnal

Chronic granulomatous mastitis is known as a benign and relatively rare disorder that is often difficult to differentiate from breast carcinoma. We highlight the case of a 34-year-old woman who had recurrent episodes of right breast swelling and abscess for 8 years. These were proven to be chronic granulomatous mastitis by tissue biopsies on 3 different occasions. Her condition improved on similar courses of antibiotics and high-dose prednisolone. However, she subsequently developed progressive loss of vision due to an orbital tumour. She then underwent a craniotomy and left orbital decompression with excision of the tumour, which proved to be a metastatic carcinoma. A trucut biopsy of the right breast was then done and showed features consistent with an infiltrating ductal carcinoma. This case illustrates the possibility that chronic granulomatous mastitis could be a precursor for malignancy and the difficulty in differentiating one from the other. The possible mechanisms of development and the implications for future management are also discussed.

Fulltext Isolated blunt lingual artery injury secondary to a road traffic accident: diagnostic and therapeutic approach

Mawaddah A, Goh BS, Kew TY, Rozman Z

Malays J Med Sci, 2012 Apr;19(2):77-81.

PMID: 22973141 MyJurnal

Neurologic and airway compromise as a result of traumatic vascular injuries to the neck region often lead to more severe complications and thus require special consideration. Furthermore, these cases pose diagnostic and therapeutic challenges to healthcare providers. Here, we report a case of a 28-year-old motorcyclist presenting with progressively enlarged Zone 2 neck swelling on the left side following a high impact collision. There were no symptoms or signs suggesting neurologic or laryngeal injury. Computed tomography angiogram of the neck revealed signs of an active arterial bleed. The apparent vascular injury was managed by close observation for signs of airway compromise, urgent angiogram, and selective catheter embolisation of the left lingual artery. The patient subsequently recovered without further operative exploration of the neck. At 6 months post-trauma, the neck swelling fully subsided with no complications from angioembolisation. This case illustrates the individualised treatment and multidisciplinary approach in managing such cases. We review our rationale for this diagnostic and therapeutic approach.

Fulltext The vanishing veins: difficult venous access in a patient requiring translumbar, transhepatic, and transcollateral central catheter insertion

Yaacob Y, Zakaria R, Mohammad Z, Ralib AR, Muda AS

Malays J Med Sci, 2011 Oct;18(4):98-102.

PMID: 22589680

Central venous catheter placement is indicated in patients requiring long-term therapy. With repeated venous catheterisations, conventional venous access sites can be exhausted. This case illustrates the expanding role of radiology in managing difficult venous access. We present a case of translumbar, transhepatic, and transcollateral placement of central catheter in a woman with a difficult venous access problem who required lifelong parenteral nutrition secondary to short bowel syndrome. This case highlights the technical aspects of interventional radiology in vascular access management.

Fulltext Heterophoria in young adults with emmetropia and myopia

Chen AH, Aziz A

Malays J Med Sci, 2003 Jan;10(1):90-4.

PMID: 23365507

The purpose of this study was to investigate the relationship between heterophoria and refractive error. Thirty-six subjects (11 myopes, 25 emmetropes) participated in this study. Heterophoria was measured with the Free-Space Phoria Card at five different viewing distances (25cm, 33cm, 50cm, 100cm and 300cm). Regardless of the types of heterophoria, the amount of heterophoria reduced towards orthophoric position with increasing viewing distance. Emmetropes and myopes did not show any significant difference in the degree of heterophoria at different viewing distances (F = 0.30, p>0.05) or in the type of heterophoria (χ(2) = 2, p>0.05).

Fulltext Reoperative thyroid surgery in hospital universiti sains malaysia

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.

Fulltext Suitability of Parkinson's patients for surgery in the north East coast of peninsular malaysia: a prospective analysis

Abdullah J, Abdullah MR

Malays J Med Sci, 2003 Jan;10(1):74-7.

PMID: 23365504 MyJurnal

There is no report in the English literature on the criteria for neuroablation or neuroaugmentation for the treatment of Parkinson's disease in a developing country like Malaysia. A prospective study of patients with Parkinson's disease from the north-eastern peninsular Malaysia was done to assess their suitability of surgery. Age, race, duration of illness and dementia were considered important factors towards the success of such surgical procedures. A mathematical model is suggested for future cases deemed to be suitable for neuroaugmentative or ablative surgery.

Fulltext Tuberculosis in AIDS patients

Nissapatorn V, Lee C, Ithoi I, Yik FM, Abdullah KA

Malays J Med Sci, 2003 Jan;10(1):60-4.

PMID: 23365502 MyJurnal

Tuberculosis is the top agenda among opportunistic diseases and the most leading cause of death in HIV/AIDS patients. A total of 406 AIDS patients were recruited in this retrospective and descriptive study. 123/406 (30.3%) were diagnosed as AIDS-related tuberculosis (TB). Their age range from 17 to 69 years with a mean (±SD) of 37.2 (±9.51. There were significant association between occupation, or mode of HIV transmission and tuberculosis infection (p< 0.05). Pulmonary tuberculosis 104/123 (84.6%) was the most common disease location among TB patients. We found the significant association between the clinical presentations i.e. fever, cough, sputum or hemoptysis and TB patients (p<0.05), moreover, the level of CD4 cell count plays a significant role in association with the disease (p<0.05) in this study.

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