MyMedR

Ossification of caroticoclinoid ligament and its clinical importance in skull-based surgery

Das S, Suri R, Kapur V

Sao Paulo Med J, 2007 Nov 01;125(6):351-3.

CONTEXT: The medial end of the posterior border of the sphenoid bone presents the anterior clinoid process (ACP), which is usually accessed for operations involving the clinoid space and the cavernous sinus. The ACP is often connected to the middle clinoid process (MCP) by a ligament known as the caroticoclinoid ligament (CCL), which may be ossified, forming the caroticoclinoid foramen (CCF). Variations in the ACP other than ossification are rare. The ossified CCL may have compressive effects on the internal carotid artery. Thus, anatomical and radiological knowledge of the ACP and the clinoid space is also important when operating on the internal carotid artery. Excision of the ACP may be required for many skull-based surgical procedures, and the presence of any anomalies such as ossified CCL may pose a problem for neurosurgeons.

CASE REPORT: We observed the presence of ossified CCL in a skull bone. A detailed radiological study of the CCL and the CCF was conducted. Morphometric measurements were recorded and photographs were taken. The ACP was connected to the MCP and was converted into a CCF. Considering the fact that standard anatomy textbooks do not provide morphological descriptions and radiological evaluations of the CCL, the present study may be important for neurosurgeons operating in the region of the ACP.

Fulltext The Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Virus in the Vaginal Fluid of Females With Severe Coronavirus Disease 2019 (COVID-19) Infection: Scientific Facts

Ahmad MF, Mahakkanukrauh P, Das S

Clin Infect Dis, 2022 Jul 06;74(12):2262-2263.

PMID: 33085746 DOI: 10.1093/cid/ciaa1608

Acute myocardial infarction in an adolescent

Muthupalaniappen L, Menon RK, Das S

Saudi Med J, 2012 Feb;33(2):197-200.

PMID: 22327763

Myocardial infarction (MI) is known to be common in adults. Interestingly, we report a case of a 15-year-old boy who presented with typical chest pain secondary to myocardial infarct attributable to a combination of familial hyperlipidemia and possible episode of Kawasaki disease in the past. The patient failed treatment and follow-up care, and died 2 years later. Although rare, this case demonstrates that MI should be considered as a diagnosis in adolescents presenting with typical chest pain as early detection, and management is vital for survival.

Fulltext Platelet changes in healthy male smokers.Scientific views

Kosai N, Rajan R, Das S

Saudi Med J, 2015 Dec;36(12):1501.

PMID: 26620998 DOI: 10.15537/smj.2015.12.12885

Fulltext A case of closed loop small bowel obstruction within a strangulated incisional hernia in association with an acute gastric volvulus

Kosai NR, Gendeh HS, Noorharisman M, Sutton PA, Das S

Acta Medica (Hradec Kralove), 2014;57(2):83-6.

PMID: 25257156 DOI: 10.14712/18059694.2014.45

Small bowel obstruction is a common clinical problem presenting with abdominal distention, colicky pain, absolute constipation and bilious vomiting. There are numerous causes, most commonly attributed to an incarcerated hernia, adhesions or obstructing mass secondary to malignancy. Here we present an unusual cause of a small bowel obstruction secondary to an incarcerated incisional hernia in association with an acute organoaxial gastric volvulus.

Detrimental effects of bisphenol A on development and functions of the male reproductive system in experimental rats

Gurmeet K, Rosnah I, Normadiah MK, Das S, Mustafa AM

EXCLI J, 2014;13:151-60.

PMID: 26417249

Bisphenol A (BPA) is widely used in manufacturing industries. It is commonly detected in the environment and was reported to exert oestrogenic effects which may be harmful to the reproductive system. The present study was carried out to observe the effects of oral administration of BPA on the development of the reproductive organs and plasma sex hormone levels in prepubertal male Sprague-Dawley (SD) rats. Prepubertal male SD rats (n=8 in each group) were administered BPA in the doses of 1, 5, 10 and 100 mg/kg BW (body weight) via oral gavage for a period of 6 weeks. The control animals received the vehicle for BPA (Tween 80 in distilled water). Following 6 weeks of BPA exposure, the rats exhibited less evidence of spermatogenesis. There was seminiferous epithelial damage which included disruption of intercellular junctions and sloughing of germ cells into the seminiferous tubular lumen. Furthermore, the lumina of the seminiferous tubules and the epididymis of these animals were filled with immature germ cells and cellular debris. This damage may lead to the significant reduction in the seminiferous tubular diameter in BPA-treated animals. These findings were associated with the significant lower plasma testosterone and 17β-oestradiol levels. There was no significant difference between the body weight gain, the absolute as well as relative testis weight or epididymal weight of BPA-treated animals when compared to the control animals. The findings provided further evidence of the detrimental effects of BPA on the male reproductive system.

Fulltext Association between hypertension and periodontitis: possible mechanisms

Leong XF, Ng CY, Badiah B, Das S

ScientificWorldJournal, 2014;2014:768237.

PMID: 24526921 DOI: 10.1155/2014/768237

This review is to examine the current literatures on the relationship between periodontitis and hypertension as well as to explore the possible biological pathways underlying the linkage between these health conditions. Hypertension is one of the major risk factors for cardiovascular diseases. Oxidative stress and endothelial dysfunction are among the critical components in the development of hypertension. Inflammation has received much attention recently and may contribute to a pivotal role in hypertension. Periodontitis, a chronic low-grade inflammation of gingival tissue, has been linked to endothelial dysfunction, with blood pressure elevation and increased mortality risk in hypertensive patients. Inflammatory biomarkers are increased in hypertensive patients with periodontitis. Over the years, various researches have been performed to evaluate the involvement of periodontitis in the initiation and progression of hypertension. Many cross-sectional studies documented an association between hypertension and periodontitis. However, more well-designed prospective population trials need to be carried out to ascertain the role of periodontitis in hypertension.

Through-knee amputation for a patient with proximal femur focal deficiency and tibial hemimelia: surgical anatomy and clinical implications

Lloyd S, Rashid AH, Das S, Ibrahim S

Anat Sci Int, 2014 Mar;89(2):122-5.

PMID: 24158808 DOI: 10.1007/s12565-013-0211-0

Tibial hemimelia is a rare anomaly of unknown etiology. This condition can occur sporadically or may have a familial inheritance. It is characterized by deficiency of the tibia with a relatively intact fibula. The anomaly may be unilateral or bilateral. We report a case of a 2-year-old girl who presented with right lower limb deformity since birth. She was diagnosed with proximal femur focal deficiency with absence of the ipsilateral tibia. She presented with a shorter right lower limb and a deformed foot. She was treated with a through-knee amputation. Anatomical dissection of the amputated limb was carried out to verify the anomalies. The dissection showed that the distal phalanx of the great toe was trifid. The anatomical and clinical significance of this interesting case is discussed.

Is increased libido an atypical symptom of bipolar depression? An interesting case

Mahadevan R, Nik Jaafar NR, Sidi H, Midin M, Das S

J Sex Med, 2013 Mar;10(3):883-6.

PMID: 23036068 DOI: 10.1111/j.1743-6109.2012.02949.x

Decreased libido is recognized as one of the vegetative symptoms of depression. Increased libido has not been acknowledged as one of its symptoms, neither has it been reported, particularly in depressed bipolar patients.

Fulltext A case of hyperosmolar hyperglycaemic state with involuntary movements - diagnostic dilemma and clinical considerations

Abd Hamid H, Umar NA, Othman H, Das S

Arch Med Sci, 2010 Dec;6(6):987-90.

PMID: 22427779 DOI: 10.5114/aoms.2010.19315

Hyperosmolar hyperglycaemic state (HHS) is a medical emergency which needs immediate medical intervention. A 37-year-old Chinese woman with a history of hypertension attended the Emergency Department. She had a two-day history of involuntary movement, i.e. chorea of the upper limbs, preceded by a one-week history of upper respiratory tract infection. She also had polyuria and polydipsia, although she was never diagnosed as diabetic. The main aim of reporting the present case was to highlight the importance of biochemical investigations involved in the diagnosis of involuntary movements.
Study site: emergency department, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)

A rare case of diplopodia and syndactyly: anatomical and surgical considerations

Kadir KH, Abdul Rashid AH, Das S, Ibrahim S

J Foot Ankle Surg, 2011 Mar-Apr;50(2):252-6.

PMID: 21354013 DOI: 10.1053/j.jfas.2010.10.017

Diplopodia is a rare congenital disorder that has not been extensively discussed in textbooks, and case reports appear to be the main source of information. Although the exact cause of diplopodia remains unknown, the presence of extra digits as well as metatarsals and tarsals allows it to be differentiated from pedal polydactyly. Syndactyly refers to the congenital fusion of the digits. Concomitant bilateral syndactyly and diplopodia is extremely unusual, and in this report we describe a case of right diplopodia and left polydactyly combined with bilateral manual syndactyly in a 15-year-old girl who was ultimately treated with through-the-knee amputation. Radiological examination of the right leg revealed tibial hypoplasia and the right foot displayed 8 digits with corresponding metatarsals and tarsals, whereas the left leg revealed 2 extra digits on the medial aspect of the foot with corresponding metatarsal and tarsal bones. Anatomical dissection of the right foot revealed that it was divided into halves consisting of 8 toes with corresponding metatarsals and tarsals, as well as tibial hypoplasia and absence of the great toe. Diplopodia associated with tibial hypoplasia and syndactyly can be treated surgically, and the present case report details the clinical, radiological, and anatomical elements of this rare deformity.

Fulltext Association of elevated blood pressure and impaired vasorelaxation in experimental Sprague-Dawley rats fed with heated vegetable oil

Leong XF, Mustafa MR, Das S, Jaarin K

Lipids Health Dis, 2010;9:66.

PMID: 20573259 DOI: 10.1186/1476-511X-9-66

Poor control of blood pressure leads to hypertension which is a major risk factor for development of cardiovascular disease. The present study aimed to explore possible mechanisms of elevation in blood pressure following consumption of heated vegetable oil.

A case of disproportionate macrodactyly or a mild form of Proteus syndrome? An interesting case

Abdullah S, Haflah NH, Sapuan J, Das S

Acta Medica (Hradec Kralove), 2010;53(4):243-6.

PMID: 21400985

We present a 20-year-old Malay male whom we believe has Proteus syndrome, a rare congenital disorder of asymmetrical overgrowth of body tissues. There are fewer than 100 confirmed cases reported worldwide thus the clinical presentation and histopathological findings are of significance. Our patient presented with an overgrown right small finger and subcutaneous purplish pigmentation over his left upper arm and chest since birth. His small finger gradually increased in size. He had no abnormalities in sensation or power. Radiographs revealed a delta shaped middle phalanx of the small finger. His activities of daily living were uninterrupted but he requested debulking surgery for cosmetic reasons. Histopathological examination reported hypertrophic fatty tissue composed of well formed lobules of mature adipocytes interspersed with fibrous elements.

Paediatric forearm fractures: functional outcome of conservative treatment

Tarmuzi NA, Abdullah S, Osman Z, Das S

Bratisl Lek Listy, 2009;110(9):563-8.

PMID: 19827340

Forearm fractures are common in the paediatric age group. Closed reduction and casting are the primary means of treatment in over 90% of these fractures. Resultant deformities are usually a product of indirect trauma involving angular loading combined with rotational deformity and fragment displacement.

Anomalous splenic notches: a cadaveric study with clinical importance

Das S, Abd Latiff A, Suhaimi FH, Ghazalli H, Othman F

Bratisl Lek Listy, 2008;109(11):513-6.

PMID: 19205563

To study the anomalous splenic notches and discuss their clinical importance.

Anomalous styloid process and its clinical implications

Das S, Suhaimi FH, Othman F, Latiff AA

Bratisl Lek Listy, 2008;109(1):31-3.

PMID: 18447260

In literature, there is paucity of information on the different shapes of styloid processes of the temporal bone of the skull. Textbooks of anatomy describe the styloid process to be slender, approximately 2.5 cm in length and concave on the anterior aspect only. In the present case, we observed the styloid process to be much longer than usual, bearing a concavity on the anterior, as well as the posterior aspects as a consequence of which, the bone was constricted in its proximal part. The mastoid process which is usually conical, was found to be rounded in this case. The length of the styloid process measured 2.8 and 2.7 cm on left and right sides, respectively. The skiagram displayed the biconcave profile of the styloid process and the rounded appearance of the mastoid process, thus substantiated the findings on gross examination of the skull. The anatomical knowledge of the mastoid process is important for surgeons assessing the mastoid air cells. The elongated styloid process is often a feature of Eagle's syndrome. An enlarged and calcified styloid process is often asymptomatic, unless detected radiologically. An abnormally elongated styloid process or its calcification may cause recurrent throat pain, foreign body sensation, dysphagia, or facial pain. An enlarged styloid process may also compress upon the internal carotid artery, leading to transient ischemic attack and may pose a threat to anesthetists performing intubation procedures. Awareness of such variations may be of clinical importance to radiologists and surgeons (Fig. 2, Ref. 11). Full Text (Free, PDF) www.bmj.sk.

A rare case of intussusception associated with metastasized small cell carcinoma of lung

Jarmin R, Azman A, Rahim R, Kosai NR, Das S

Acta Med Iran, 2012;50(11):782-4.

PMID: 23292632

Intussusception is common cause of bowel obstruction in the paediatric age group compared to the elderly population. Many times, the diagnosis may be difficult because of asymptomatic nature of this bowel disorder. We hereby describe the case of a 75-year-old male who presented with lethargy, weakness, loss of movement in the joints and was found to be anemic. The haemoglobin level was low so he was transfused with packed cells. On gastrointestinal (GI) endoscopy, upper GI bleed was observed. A mass was observed beyond ampulla at the 2nd and 3rd part of the duodenal junction. Computerized tomography (CT) scan also showed a mass at the head of pancreas and the lesion at the left lung. In view of persistent bleed, 'Whipple's procedure' was performed. Histopathological examination showed small cell carcinoma of the lungs with metastasis to the pancreas and the jejunum. We here discuss the case of intussusception with intestinal metastasis which presented with gastrointestinal bleeding.

Heated palm oil causes rise in blood pressure and cardiac changes in heart muscle in experimental rats

Leong XF, Aishah A, Nor Aini U, Das S, Jaarin K

Arch Med Res, 2008 Aug;39(6):567-72.

PMID: 18662587 DOI: 10.1016/j.arcmed.2008.04.009

Palm oil used worldwide contains considerable amounts of antioxidants, namely, vitamin E and carotenes. The purpose of the study was to observe the effect of heated palm oil on blood pressure and observe the cardiac histological changes in rats.

Fulltext Role of microRNAs in Diagnosis, Prognosis and Management of Multiple Myeloma

Soliman AM, Lin TS, Mahakkanukrauh P, Das S

Int J Mol Sci, 2020 Oct 13;21(20).

PMID: 33066062 DOI: 10.3390/ijms21207539

Multiple myeloma (MM) is a cancerous bone disease characterized by malignant transformation of plasma cells in the bone marrow. MM is considered to be the second most common blood malignancy, with 20,000 new cases reported every year in the USA. Extensive research is currently enduring to validate diagnostic and therapeutic means to manage MM. microRNAs (miRNAs) were shown to be dysregulated in MM cases and to have a potential role in either progression or suppression of MM. Therefore, researchers investigated miRNAs levels in MM plasma cells and created tools to test their impact on tumor growth. In the present review, we discuss the most recently discovered miRNAs and their regulation in MM. Furthermore, we emphasized utilizing miRNAs as potential targets in the diagnosis, prognosis and treatment of MM, which can be useful for future clinical management.

Therapeutic Targeting of Inflammatory Pathways with Emphasis on NLRP3 Inflammasomes by Natural Products: A Novel Approach for the Treatment of Inflammatory Eye Diseases

Soliman AM, Sim RH, Das S, Mahakkannurauh P

Curr Med Chem, 2021 Sep 10.

PMID: 34514977 DOI: 10.2174/0929867328666210910154330

There is an increase in the incidence of inflammatory eye diseases worldwide. Several dysregulated inflammatory pathways, including the NOD-like receptor protein 3 (NLRP3) inflammasome, have been reported to contribute significantly to the pathogenesis and progression of ophthalmic diseases. Although the available allopathic/conventional medicine has demonstrated effectiveness in managing eye diseases, there is an ongoing global demand for alternative therapeutics with minimal adverse drug reactions, easy availability, increase in patient-compliance, and better disease outcome. Therefore, several studies are investigating the utilization of natural products and herbal formulations in impeding inflammatory pathways, including the NLRP3 inflammasome, in order to prevent or manage eye diseases. In the present review, we highlight the recently reported inflammatory pathways with special emphasis on NLRP3 Inflammasomes involved in the development of eye diseases. Furthermore, we present a variety of natural products and phytochemicals that were reported to interfere with these pathways and their underlying mechanisms of action. These natural products represent potential therapeutic applications for the treatment of several inflammatory eye diseases.

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