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Fulltext Update on the management of peripheral arterial disease (PAD)

Liew NC, Moissinac K, Lee L, Gee T, Zezeman RB

Med J Malaysia, 2011 Oct;66(4):386-8; quiz 389.
PMID: 22299571 MyJurnal

There has been much progress made in the management of peripheral arterial disease (PAD) in the past two decades. Progress in the understanding of the endothelial-platelet interaction during health and disease state have resulted in better antiplatelet drugs that can prevent platelet aggregation, activation and thrombosis during angioplasty and stenting. Collaborative effort by different international societies has resulted in a consensus guideline that recommends the modality of intervention in certain disease states. Progress in perioperative care has reduced the morbidity and mortality associated with peripheral vascular reconstruction surgery. Nevertheless, the advances in percutaneous peripheral intervention (PPI) have made a paradigm shift in the current management of patients. The procedure is safe and effective and is emerging as the first choice revascularization procedure.

Matched MeSH terms: Peripheral Arterial Disease/therapy*
Fulltext The impact of the wavelet propagation distribution on SEIRS modeling with delay

Apenteng OO, Ismail NA

PLoS One, 2014;9(6):e98288.
PMID: 24911023 DOI: 10.1371/journal.pone.0098288

Previous models of disease spread involving delay have used basic SIR (susceptible--infectious--recovery) formulae and approaches. This paper demonstrates how time-varying SEIRS (S--exposed--I - R - S) models can be extended with delay to produce wave propagations that simulate periodic wave fronts of disease spread in the context of population movements. The model also takes into account the natural mortality associated with the disease spread. Understanding the delay of an infectious disease is critical when attempting to predict where and how fast the disease will propagate. We use cellular automata to model the delay and its effect on the spread of infectious diseases where population movement occurs. We illustrate an approach using wavelet transform analysis to understand the impact of the delay on the spread of infectious diseases. The results indicate that including delay provides novel ways to understand the effects of migration and population movement on disease spread.

Matched MeSH terms: Disease Susceptibility*
Temporal and spatial mapping of hand, foot and mouth disease in Sarawak, Malaysia

Sham NM, Krishnarajah I, Ibrahim NA, Lye MS

Geospat Health, 2014 May;8(2):503-7.
PMID: 24893027

Hand, foot and mouth disease (HFMD) is endemic in Sarawak, Malaysia. In this study, a geographical information system (GIS) was used to investigate the relationship between the reported HFMD cases and the spatial patterns in 11 districts of Sarawak from 2006 to 2012. Within this 7-years period, the highest number of reported HFMD cases occurred in 2006, followed by 2012, 2008, 2009, 2007, 2010 and 2011, in descending order. However, while there was no significant distribution pattern or clustering in the first part of the study period (2006 to 2011) based on Moran's I statistic, spatial autocorrelation (P = 0.068) was observed in 2012.

Matched MeSH terms: Hand, Foot and Mouth Disease/epidemiology*
Fulltext A pilot randomized control cross over study evaluating the effectiveness and safety of mechanical percussor compared with conventional chest physiotherapy in adults with productive cough

Punithavathi N, Ong LM, Irfhan Ali HA, Mohd Izmi IA, Dharminy T, Ang AH, et al.

Med J Malaysia, 2014 Feb;69(1):16-20.
PMID: 24814623 MyJurnal

INTRODUCTION: Conventional Chest Physiotherapy (CCPT) remains the mainstay of treatment for sputum mobilization in patients with productive cough such as bronchiectasis and "Chronic Obstructive Airway Disease" (COPD). However CCPT is time consuming requires the assistance of a physiotherapist and limits the independence of the patient. Mechanical percussors which are electrical devices used to provide percussion to the external chest wall might provide autonomy and greater compliance. We compared safety and efficacy of a mechanical chest percusser devised by Formedic Technology with conventional chest percussion.
METHODS: Twenty patients (mean age 64years) were randomly assigned to receive either CCPT or mechanical percussor on the first day and crossed over by "Latin square randomisation" to alternative treatment for 6 consecutive days and the amount of sputum expectorated was compared by dry and wet weight. Adverse events and willingness to use was assessed by a home diary and a questionnaire.
RESULTS: There were 13 males and 7 females, eight diagnosed as bronchiectasis and 12 COPD. The mean dry weight of sputum induced by CCPT (0.54g ± 0.32) was significantly more compared with MP (0.40g + 0.11); p-value = 0.002. The mean wet weight of sputum with CCPT (10.71g ± 8.70) was also significantly more compared with MP (5.99g ± 4.5); p-value < 0.001. There were no significant difference in adverse events and majority of patients were willing to use the device by themselves.
CONCLUSION: The mechanical percussor although produces less sputum is well tolerated and can be a useful adjunct to CCPT.

Matched MeSH terms: Pulmonary Disease, Chronic Obstructive*
Fulltext Cinnamon: a multifaceted medicinal plant

Rao PV, Gan SH

Evid Based Complement Alternat Med, 2014;2014:642942.
PMID: 24817901 DOI: 10.1155/2014/642942

Cinnamon (Cinnamomum zeylanicum, and Cinnamon cassia), the eternal tree of tropical medicine, belongs to the Lauraceae family. Cinnamon is one of the most important spices used daily by people all over the world. Cinnamon primarily contains vital oils and other derivatives, such as cinnamaldehyde, cinnamic acid, and cinnamate. In addition to being an antioxidant, anti-inflammatory, antidiabetic, antimicrobial, anticancer, lipid-lowering, and cardiovascular-disease-lowering compound, cinnamon has also been reported to have activities against neurological disorders, such as Parkinson's and Alzheimer's diseases. This review illustrates the pharmacological prospective of cinnamon and its use in daily life.

Matched MeSH terms: Alzheimer Disease; Parkinson Disease
Fulltext Gene technology for papaya ringspot virus disease management

Azad MA, Amin L, Sidik NM

ScientificWorldJournal, 2014;2014:768038.
PMID: 24757435 DOI: 10.1155/2014/768038

Papaya (Carica papaya) is severely damaged by the papaya ringspot virus (PRSV). This review focuses on the development of PRSV resistant transgenic papaya through gene technology. The genetic diversity of PRSV depends upon geographical distribution and the influence of PRSV disease management on a sequence of PRSV isolates. The concept of pathogen-derived resistance has been employed for the development of transgenic papaya, using a coat protein-mediated, RNA-silencing mechanism and replicase gene-mediated transformation for effective PRSV disease management. The development of PRSV-resistant papaya via post-transcriptional gene silencing is a promising technology for PRSV disease management. PRSV-resistant transgenic papaya is environmentally safe and has no harmful effects on human health. Recent studies have revealed that the success of adoption of transgenic papaya depends upon the application, it being a commercially viable product, bio-safety regulatory issues, trade regulations, and the wider social acceptance of the technology. This review discusses the genome and the genetic diversity of PRSV, host range determinants, molecular diagnosis, disease management strategies, the development of transgenic papaya, environmental issues, issues in the adoption of transgenic papaya, and future directions for research.

Matched MeSH terms: Disease Management*
Fulltext Colonization of Anopheles cracens: a malaria vector of emerging importance

Amir A, Sum JS, Lau YL, Vythilingam I, Fong MY

Parasit Vectors, 2013;6:81.
PMID: 23537404 DOI: 10.1186/1756-3305-6-81

Anopheles cracens has been incriminated as a vector for the simian malaria parasite, Plasmodium knowlesi, that is the fifth Plasmodium species infecting humans. Little experimental data exists on this mosquito species due to the lack of its availability in laboratories.

Matched MeSH terms: Disease Vectors*
Fulltext Dual thyroid ectopia with graves' disease: a case report and a review of the literature

Tan TH, Lee BN, Amir Hassan SZ, Ch'ng ES, Hussein Z

Nucl Med Mol Imaging, 2012 Dec;46(4):300-3.
PMID: 24900078 DOI: 10.1007/s13139-012-0160-x

Ectopic thyroid or thyroid ectopia is a rare developmental anomaly with the prevalence of 1 per 100,000-300,000 population. Even rarer, such an anomaly manifests as dual thyroid ectopia. To our best knowledge, only one case has been reported on dual thyroid ectopia with Graves' disease in the English literature. We present here a case of dual thyroid ectopia complicated by Graves' disease, whereby the diagnosis was rendered through judicious use of various diagnostic modalities coupled with a close clinical follow-up. In this case, therapeutic consideration should be personalized with proper informed consent of the patient.

Matched MeSH terms: Graves Disease*
Fulltext Use of expansion factors to estimate the burden of dengue in Southeast Asia: a systematic analysis

Undurraga EA, Halasa YA, Shepard DS

PLoS Negl Trop Dis, 2013;7(2):e2056.
PMID: 23437407 DOI: 10.1371/journal.pntd.0002056

BACKGROUND: Dengue virus infection is the most common arthropod-borne disease of humans and its geographical range and infection rates are increasing. Health policy decisions require information about the disease burden, but surveillance systems usually underreport the total number of cases. These may be estimated by multiplying reported cases by an expansion factor (EF).
METHODS AND FINDINGS: As a key step to estimate the economic and disease burden of dengue in Southeast Asia (SEA), we projected dengue cases from 2001 through 2010 using EFs. We conducted a systematic literature review (1995-2011) and identified 11 published articles reporting original, empirically derived EFs or the necessary data, and 11 additional relevant studies. To estimate EFs for total cases in countries where no empirical studies were available, we extrapolated data based on the statistically significant inverse relationship between an index of a country's health system quality and its observed reporting rate. We compiled an average 386,000 dengue episodes reported annually to surveillance systems in the region, and projected about 2.92 million dengue episodes. We conducted a probabilistic sensitivity analysis, simultaneously varying the most important parameters in 20,000 Monte Carlo simulations, and derived 95% certainty level of 2.73-3.38 million dengue episodes. We estimated an overall EF in SEA of 7.6 (95% certainty level: 7.0-8.8) dengue cases for every case reported, with an EF range of 3.8 for Malaysia to 19.0 in East Timor.
CONCLUSION: Studies that make no adjustment for underreporting would seriously understate the burden and cost of dengue in SEA and elsewhere. As the sites of the empirical studies we identified were not randomly chosen, the exact extent of underreporting remains uncertain. Nevertheless, the results reported here, based on a systematic analysis of the available literature, show general consistency and provide a reasonable empirical basis to adjust for underreporting.

Matched MeSH terms: Disease Notification/statistics & numerical data
Blast resistance in rice: a review of conventional breeding to molecular approaches

Miah G, Rafii MY, Ismail MR, Puteh AB, Rahim HA, Asfaliza R, et al.

Mol Biol Rep, 2013 Mar;40(3):2369-88.
PMID: 23184051 DOI: 10.1007/s11033-012-2318-0

Blast disease caused by the fungal pathogen Magnaporthe oryzae is the most severe diseases of rice. Using classical plant breeding techniques, breeders have developed a number of blast resistant cultivars adapted to different rice growing regions worldwide. However, the rice industry remains threatened by blast disease due to the instability of blast fungus. Recent advances in rice genomics provide additional tools for plant breeders to improve rice production systems that would be environmentally friendly. This article outlines the application of conventional breeding, tissue culture and DNA-based markers that are used for accelerating the development of blast resistant rice cultivars. The best way for controlling the disease is to incorporate both qualitative and quantitative genes in resistant variety. Through conventional and molecular breeding many blast-resistant varieties have been developed. Conventional breeding for disease resistance is tedious, time consuming and mostly dependent on environment as compare to molecular breeding particularly marker assisted selection, which is easier, highly efficient and precise. For effective management of blast disease, breeding work should be focused on utilizing the broad spectrum of resistance genes and pyramiding genes and quantitative trait loci. Marker assisted selection provides potential solution to some of the problems that conventional breeding cannot resolve. In recent years, blast resistant genes have introgressed into Luhui 17, G46B, Zhenshan 97B, Jin 23B, CO39, IR50, Pusa1602 and Pusa1603 lines through marker assisted selection. Introduction of exotic genes for resistance induced the occurrence of new races of blast fungus, therefore breeding work should be concentrated in local resistance genes. This review focuses on the conventional breeding to the latest molecular progress in blast disease resistance in rice. This update information will be helpful guidance for rice breeders to develop durable blast resistant rice variety through marker assisted selection.

Matched MeSH terms: Disease Resistance/genetics*
Fulltext Prevalence of peripheral arterial disease and abdominal aortic aneurysm among patients with acute coronary syndrome

Leong BDK, Ariffin AZ, Chuah JA, Voo SY

Med J Malaysia, 2013;68(1):10-2.
PMID: 23466759 MyJurnal

INTRODUCTION: Peripheral arterial disease(PAD) and abdominal aortic aneurysm(AAA) are two important underdiagnosed vascular pathologies. As they share common risk factors with coronary arterial disease, we conducted a study to look at their prevalence among patients with acute coronary syndrome(ACS).
MATERIALS AND METHODS: Patients with ACS admitted to Queen Elizabeth Hospital, Malaysia, from February 2009 till August 2009 were screened prospectively for PVD and AAA. Patients' data and clinical findings were gathered and analyzed. Measurements of ankle brachial index (ABI) and abdominal aortic diameter were performed by a single assessor. PAD was defined as ABI ≤ 0.9 or diabetic patients with signs and symptoms of PAD and absence of pedal pulses. AAA was defined as abdominal aortic diameter ≥ 3cm.
RESULTS: 102 patients were recruited with mean age of 59.5 years old. Male: female ratio was 6:1. 40.2% of patients had NSTEMI; 45.1%, STEMI and 14.7%, unstable angina. Risk factors profile is as follows: hypertension- 68.6%, smoking- 56.9%, hypercholesterolemia- 52.9%, diabetes mellitus- 35.3% and history of stroke- 5.9%. Median ABI was 1.1 with lowest reading of 0.4. Mean abdominal aortic size was 2.0cm with largest diameter of 3.3cm. PAD was present in 24.5% of patients and AAA in 2.0%. 68.0% of patients with PAD were asymptomatic. Smoking and age more than 60 years were independent predictors for PAD among ACS patients.
CONCLUSIONS: PAD is strongly correlated with CAD with old age and smoker as independent predictors. However, association between AAA and ACS could not be established.
Study site: Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia

Matched MeSH terms: Peripheral Arterial Disease*
Fulltext The rabbit as a model for studying lung disease and stem cell therapy

Kamaruzaman NA, Kardia E, Kamaldin N', Latahir AZ, Yahaya BH

Biomed Res Int, 2013;2013:691830.
PMID: 23653896 DOI: 10.1155/2013/691830

No single animal model can reproduce all of the human features of both acute and chronic lung diseases. However, the rabbit is a reliable model and clinically relevant facsimile of human disease. The similarities between rabbits and humans in terms of airway anatomy and responses to inflammatory mediators highlight the value of this species in the investigation of lung disease pathophysiology and in the development of therapeutic agents. The inflammatory responses shown by the rabbit model, especially in the case of asthma, are comparable with those that occur in humans. The allergic rabbit model has been used extensively in drug screening tests, and this model and humans appear to be sensitive to similar drugs. In addition, recent studies have shown that the rabbit serves as a good platform for cell delivery for the purpose of stem-cell-based therapy.

Matched MeSH terms: Disease Models, Animal*
Fulltext Iatrogenic corneal perforation in Terrien Marginal Degeneration

Mohd Razali K

Med J Malaysia, 2013 Apr;68(2):173-4.
PMID: 23629570 MyJurnal

This case report is about a rare disease with unusual presentation. Failure to recognise atypical presentation may lead to error in managing the patient and cause disastrous complications. Here we highlight a case of Terrien Marginal Degeneration in both eyes with atypical presentation; namely pseudopterygium. A 22 year old man was referred to our centre for iatrogenic right eye corneal perforation after having an atypical pterygium removed at another hospital. On arrival, his vision was 1/60 in both eyes with bilateral cornea Terrien Marginal Degeneration. His right eye anterior chamber was deep with a conjunctival flap covering the perforation site which was located from the 2.30 - 3.30 clock position nasally with no aqueous leak. However after a day his right eye anterior chamber became flat and there was fast aqueous leak from the perforation site. An emergency C shaped peripheral corneal lamellar keratoplasty was performed to seal the perforation. Post operatively his right eye improved to 6/24.

Matched MeSH terms: Iatrogenic Disease*
Prevalence of overweight and self-reported chronic diseases among residents in Pulau Kundur, Kelantan, Malaysia

Nazri SM, Imran MK, Ismail IM, Faris AA

Southeast Asian J Trop Med Public Health, 2008 Jan;39(1):162-7.
PMID: 18567457

This cross-sectional study was designed to determine the socio-demographic characteristics and prevalence of overweight/obesity and self-reported diabetes mellitus, hypertension and heart disease among the population in Pulau Kundur, Kota Bharu, Kelantan, Malaysia. This study was conducted in September 2005. We randomly selected 120 of 240 households in Pulau Kundur, Kota Bharu, Kelantan. Fifteen interviewers were trained to use a structured questionnaire to interview 348 adult respondents age 18 years and older in the selected houses. The mean age was 40.7 years; 52.7% were females and 99.4% were Malay. Sixty-two point seven percent were married and 50.9% of them had Ujian Penilaian Sekolah Rendah (UPSR) or less education. The mean head of family income was RM 532.4. The mean body mass index was 25.3. The overall prevalence of overweight/obesity, known hypertension, diabetes mellitus and heart disease were 49.1, 12.6, 7.8 and 2.0% respectively. Adults in this village had a high prevalence of overweight and obesity and self-reported chronic diseases. Health education and lifestyle modification are needed for those adults.

Matched MeSH terms: Chronic Disease/epidemiology*
Fulltext Acute dengue in a neonate secondary to perinatal transmission

Chin PS, Khoo AP, Asmah Hani AW, Chem YK, Norizah I, Chua KB

Med J Malaysia, 2008 Aug;63(3):265-6.
PMID: 19248708 MyJurnal

We report a newborn baby girl with acute dengue due to vertical transmission. A 31 year old factory worker of 38+ week gestation, gravida 5 para 3+1, developed acute dengue fever two days prior to delivery. She delivered a normal term baby girl by spontaneous vaginal delivery and recovered uneventfully without peripartum haemorrhage despite the presence of thrombocytopenia. The baby girl developed low grade fever on day four of post-natal life and except for the transient thrombocytopenia, also recovered uneventfully following three days of mild illness. The clinical diagnosis of acute dengue virus infection was confirmed by laboratory tests.

Matched MeSH terms: Infectious Disease Transmission, Vertical*
Fulltext Changes in nutritional, functional status and quality of life of COPD out-patients after a pulmonary rehabilitation programme in HUKM: a pilot study

Suzana S, Hanis MY, Tang SY, Ayiesah R, Roslina AM

Malays J Nutr, 2008 Sep;14(2):151-62.
PMID: 22691772 MyJurnal

This quasi-experimental study was carried out to evaluate the effectiveness of an eight-week multi-disciplinary pulmonary rehabilitation programme in improving nutritional and functional status and quality of life of COPD out patients at Hospital Universiti Kebangsaan Malaysia. A total of 9 COPD outpatients aged 40 years and above (6 men and 3 women) completed at least 50% of 16 sessions of an eight-week pulmonary rehabilitation programme. Their nutritional and functional status and rating of quality of life were measured at baseline (0 day) and after 8 weeks and these were compared to those of the control group matched for age, comprising 13 subjects (11 men and 2 women). Nutritional status was determined using anthropometry, body composition (Bioelectrical Impedance Analysis) and three-day food record. Assessment of appetite for food was also carried out using the Simplified Nutritional Assessment Questionnaire (SNAQ). Functional status was assessed using the Pulmonary Functional Status and Dyspnea Questionnaire-modified version(PFSDQ-M). The handgrip strength was also measured using handgrip dynamometer. The SF36 questionnaire was used to measure the quality of life of the subjects. There was a reduction in dyspnea (-49.0%, p<0.05) and fatigue (-47.8%, p<0.05) in men after the intervention programme, as compared to their controls (dyspnea -2.9% and fatigue 8.9%). Quality of life in this group was also significantly improved by 31.8% (p<0.05) as compared to their controls (-3.0%,p>0.05). Similar trends were noted for the women, although the difference was not significant. No significant changes were seen in nutritional status assessed by anthropometry, dietary intake and appetite. However, there was a trend of increased nutrient intake and SNAQ score in the intervention group as compared to control. An eight-week pulmonary rehabilitation programme was effective in improving the functional status particularly in men, by reducing dyspnea and fatigue; and also improving their quality of life, but was not effective in changing the nutritional status.
Study site: Physiotherapy Unit, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia

Matched MeSH terms: Pulmonary Disease, Chronic Obstructive*
Fulltext Recurrent Chromobacterium violaceum infection in a patient with chronic granulomatous disease

Sureisen M, Choon SK, Tai CC

Med J Malaysia, 2008 Oct;63(4):346-7.
PMID: 19385503 MyJurnal

We report a rare case of recurrent infection of Chromobacterium violaceum in an immunocompromised patient. Despite the high mortality rate associated with this infection as reported in the literature, this patient survived three episodes of recurrent infection. We believe that with high clinical suspicion, prompt treatment and appropriate antimicrobial agents, it is possible for clinicians to treat this infection effectively and reduce the mortality rate.

Matched MeSH terms: Granulomatous Disease, Chronic/complications*
Fulltext Ovitrap surveillance of the dengue vectors, Aedes (Stegomyia) aegypti (L.) and Aedes (Stegomyia) albopictus Skuse in selected areas in Bentong, Pahang, Malaysia

Norzahira R, Hidayatulfathi O, Wong HM, Cheryl A, Firdaus R, Chew HS, et al.

Trop Biomed, 2011 Apr;28(1):48-54.
PMID: 21602768 MyJurnal

Ovitrap surveillance was conducted in methodically selected areas in Bentong, Pahang, Malaysia from June 2008 till December 2009 in order to identify insular sites with stable Aedes aegypti population. Eleven sites were surveyed in Bentong district, Pahang, and one of these locations (N3º33' E101º54') was found to have an ovitrap index of Ae. aegypti and Aedes albopictus ranging from 8%-47% and 37%-78% respectively, indicating that this site could be a high-risk area for dengue outbreak. Ae. aegypti larvae were found in both indoor and outdoor ovitraps (p>0.05) while significant difference between the populations of Ae. albopictus larvae from indoors and outdoors was observed (p<0.01). Data collected in this study could provide important entomological information for designing an effective integrated vector control programme to combat Aedes mosquitoes in this area.

Matched MeSH terms: Disease Vectors*
Fulltext Emerging epidemic viral encephalitides with a special focus on henipaviruses

Wong KT

Acta Neuropathol, 2010 Sep;120(3):317-25.
PMID: 20652579 DOI: 10.1007/s00401-010-0720-z

In the last few decades, there is an increasing emergence and re-emergence of viruses, such as West Nile virus, Enterovirus 71 and henipaviruses that cause epidemic viral encephalitis and other central nervous system (CNS) manifestations. The mortality and morbidity associated with these outbreaks are significant and frequently severe. While aspects of epidemiology, basic virology, etc., may be known, the pathology and pathogenesis are often less so, partly due to a lack of interest among pathologists or because many of these infections are considered "third world" diseases. In the study of epidemic viral encephalitis, the pathologist's role in unravelling the pathology and pathogenesis is critical. The novel henipavirus infection is a good example. The newly created genus Henipavirus within the family Paramyxoviridae consists of two viruses, viz., Hendra virus and Nipah virus. These two viruses emerged in Australia and Asia, respectively, to cause severe encephalitides in humans and animals. Studies show that the pathological features of the acute encephalitis caused by henipaviruses are similar and a unique dual pathogenetic mechanism of vasculitis-induced microinfarction and parenchymal cell infection in the CNS (mainly neurons) and other organs causes severe tissue damage. Both viruses can cause relapsing encephalitis months and years after the acute infection due to a true recurrent infection as evidenced by the presence of virus in infected cells. Future emerging viral encephalitides will no doubt continue to pose considerable challenges to the neuropathologist, and as the West Nile virus outbreak demonstrates, even economically advanced nations are not spared.

Matched MeSH terms: Disease Outbreaks*
Right heterotaxy with Hirschsprung's disease - a new association

Thambi Dorai CR, Hamzaini H, Rohana R

Clin Anat, 2010 May;23(4):455-9.
PMID: 20196129 DOI: 10.1002/ca.20949

A baby girl with prenatal diagnosis of complex cardiac anomalies and diaphragmatic hernia was born at 36 weeks of gestation. At 4 hr of life, the baby developed respiratory distress and was intubated. She was found to have right hetetrotaxy with total anomalous pulmonary venous drainage into the portal vein, five hepatic veins draining the liver and intrathoracic herniation of the stomach. The child also developed abdominal distension on the second day of life with passage of scanty meconium. The diagnosis of Hirschsprung's disease (HD) was confirmed by histology. HD in association with right heterotaxy has not been reported earlier. The association of heterotaxy with HD in our patient raises a possible genetic link between the two anomalies that needs further research.

Matched MeSH terms: Hirschsprung Disease/pathology*

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