Displaying publications 61 - 80 of 464 in total

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  1. Roszaman, R., Ghazali Ismail
    MyJurnal
    Choriocarcinoma is a malignant proliferation of syncytial trophoblast cells that do not form placental villi. It is a relatively rare and highly malignant variant of gestational trophoblastic disease. Although choriocarcinoma is mostly observed after a molar pregnancy, it may be preceded by any gestational event. It has been shown that even a partial mole can transform into choricarcinoma. Incidence rates of choriocarcinoma differ widely throughout the world. In Europe and North America, choriocarcinoma is reported to affect one in every 30,000 to 40,000 pregnancies, and one in 40 molar pregnancies. In South East Asia, choriocarcinoma is reported to affect one in every 500-3000 pregnancies. Following livebirth, choriocarcinoma with metastatic disease are important sequele (31%)(Tidy et al 1995). In the same study the reported median interval between antecedent pregnancy and choriocarcinoma is five months. Multi agent chemotherapy is required in the majority of patients (82%) for the high risk group. The prognosis for choriocarcinoma after a normal gestation is poorer. The mortality rate is also significantly higher than non-molar abortion (21%). Effective treatment with oral Methotrexate in metastatic choriocarcinoma to the lung confirmed the highly sensitive nature of this tumour to chemotherapy agent.
  2. Hadi, M.R.A., Basri, M.N., Ariff, O.
    MyJurnal
    The use of thrombolytic agent e.g. streptokinase is indicated in patients with early acute ST elevation myocardial infarction (MI) (if there are no contraindications) is becoming increasingly routine. Its use is however significantly limited by bleeding complications. Spinal epidural haematoma (SEH) is haemorrhage in the spinal epidural space after spinal anaesthesia. SEH may be acute or chronic, spontaneous, posttraumatic, or iatrogenic but its occurrence appears to be particularly associated with acquired coagulopathy from medications and disease states. Patients usually present with acute axial spine pain and evolving focal neurological deficits. With increasing number of available anticoagulants and patient receiving them, anaesthesiologists today have to face the challenge of balancing between risks and benefits of regional anesthesia in patients under such medications. The treatment of this condition involves the principles of conservative follow-up directed by an improving examination and an understanding of the pathophysiology of coagulopathy-induced spontaneous epidural bleeds. When the diagnosis is accomplished rapidly, surgical decompression can result in full functional recovery.
  3. Roszaman Ramli, Mokhtar Awang, Ghazali Ismail
    MyJurnal
    Pelvic inflammatory disease (PID) is a common cause of morbidity and accounts for 1 in 60 GP consultations by women under the age of 45 in the UK. Pelvic inflammatory disease encompases a broad category of disease including endometritis, salphingitis, salphingo-oopheritis, tuboovarian abscess and pelvic peritonitis. It most commonly occurs as a result of Chlamydia trachomatis or Nesseria gonorrhea 1,2 infection of the endocervix that eventually spread into the upper genital tract. Direct spread from a nearby infection such as appendicitis and diverticulitis is not that common. Hematogenous spread is rare except in cases of tuberculous pelvic inflammatory disease. This case illustrates atypical presentation of pelvic inflammatory disease in a previously healthy single unmarried lady. The presence of ascites, bilateral ovarian mass and constitutional symptoms closely mimics that of malignant ovarian tumour. This was preceded by empyema which grew E coli.
  4. Yousuf, R.M., Kausar, R.
    MyJurnal
    Restrictive dietetic practices, rather than helping the patient, reduce his food intake and thereby impair recovery. This is a cruelty born-of erroneous notion passed on to us as a legacy from hakims and vaids (quakes), rather than having any scientific justification. Even if some doctors do not entertain such restrictions, the so called well-wishers of patients will definitely offer free advice and impose food restrictions upon their patients. Everybody has his own share of bitter experiences, horrific memories, and heart-rending stories of the past. The chain of death and destruction remains unbroken. The gloomy, dark sky is waiting for break of a new dawn gone into eclipse years before. The ongoing Indo- Pak peace process has already resulted in a number of confidence- building measures, but in spite of all that an average of five persons each day are being killed in terror-related incidents across the State. A tricky situation prevails in which militants and security forces are pitted against each other, converting the streets, the lanes and by-lanes, and human settlements in to a well-entrenched battle ground. Innocent Kashmir’s are dying, getting maimed, and suffering mental agony and the world is watching with a nonchalant indifference.
  5. Amran, A.R., Ranganathan, S.
    MyJurnal
    Hepatocellular carcinoma (HCC) presenting with right atrial metastases and pulmonary tumour embolism is rare . Intracavitary cardiac metastasis is uncommon and metastasis to the right atrium is even less common. The majority of such cases are believed to be due to advanced HCC such as Stage III or IV, in which the progression rate is high, and in infiltrative HCC it tends to be associated with vascular invasion. The diagnosis of pulmonary intravascular tumour emboli is difficult to establish both clinically and with conventional radiographic studies. We report a case hepatocellular carcinoma associated with tumour thrombus in the inferior vena cava (IVC), right atrium and pulmonary tumour embolism detected with multidetector helical computerized tomography (MDHCT).
  6. Amran, A.R., Moosa, F.
    MyJurnal
    Extramedullary hematopoiesis (EH) is a rare but well-known compensatory mechanism of red blood cell production when the normal site of red bone marrow is unable to produce sufficient number of red blood cells. When the body demands for erythrocyte cells is high this lead to EH. This occurs mainly outside the bone marrow, usually paraspinally and sites which are normally observed in the fetus as in the liver, spleen, lymph nodes and less frequently at other sites such as adrenal, thymus, kidneys, pleura, breast, skin, gastrointestinal tract, dura mater and brain.This is more frequent in thalassaemia major (incidence up to 15% of cases), in myelofibrosis, myeloproliferative diseases (polycythemia rubra vera, chronic myeloid leukemia,), hemolytic anemias such as hereditary spherocytosis, pyruvate-kinase deficiency, medullary tuberculosis and in Paget’s disease of the bone. In some cases the cause of the EH are not identified [3]. We describe a case of EH in the presacral space that mimicked an ovarian mass on ultrasound in a patient with beta-thalassaemia intermedia.
  7. Amran, A.R.
    MyJurnal
    Pulmonary sequestration is defined as a segment of ç separated from the tracheobronchial tree and receiving its blood supply from a systemic artery rather than a pulmonary arterial branch. Classically, it has been described in two forms: (1) intralobar sequestration (ILS), in which the sequestrated part of lung lies within normal pulmonary visceral pleura, and (2) extralobar sequestration (ELS), in which the abnormal segment of lung is completely separate and enclosed in its own pleural investment. The term sequestration was coined by Pryce in 1946 to describe a disconnected bronchopulmonary mass or cyst with an anomalous systemic artery. Since this original description, terminology has become confusing as investigator has recognized many variants of sequestration not strictly meeting the original description. The spectrum now recognized as a continuum, with normal vessels supplying abnormal lung at one end and abnormal vessels supplying normal lung at the other end. Recently, we incidentally found an asymptomatic, intralobar pulmonary sequestration during CT pneumocolon.
  8. Hamidon, B.B., Sapiah, S.
    MyJurnal
    A 72-year old Englishman was admitted with rapid deterioration in cognitive function, gait disturbance, and cerebellar signs and lapsed into a coma within one week of admission to the hospital. He had long-standing hypertension and hypercholesterolaemia, for which he was on regular medication. He had suffered recurrent episodes of stroke between September 1997 and May 2001. Three months prior to presentation, he became forgetful and generally mentally slow, affecting his daily activities. He was also noted to have fluctuations in his conscious level, associated with myoclonic jerks of the limbs. The brain MRI revealed hyperintense lesions on T2- weighted images in the periventricular region, left corona radiata, centrum semiovale, pons, midbrain and right thalamus. The electroencephalograph revealed periodic sharp wave complexes, strongly suggestive of Creutzfeldt-Jakob disease. However, we were not able to get a tissue diagnosis or send the cerebrospinal fluid for protein 14-3-3.
  9. Roszaman Ramli, Ghazali Ismail
    MyJurnal
    Vaginal agenesis is a rare event occurring at a frequency of 1 case per 4000-10 000 female lives born. The most common etiology of vaginal agenesis is congenital absence of the uterus and vagina called mullerian agenesis (Mayer-Rokitansky-Hauser Syndrome). Although most patients with mullerian agenesis have small rudimentary 2 ‘mullerian bulbs’ without any endometrial activity, 7-8% of these cases possibly have a functioning uterus 3. In vaginal agenesis, genetic females are thought to have persistence of mullerian inhibiting factor MIF, resulting in failure of the vagina and uterus to develop 4. The ovaries, given their separate embryonic source, are normal in structure and function. This condition usually goes undetected until these patients reach puberty, when they start to experience cyclic pelvic pain due to the accumulation of menstrual blood.
  10. Roszaman Ramli, Ahmad Murad Zainudin
    MyJurnal
    Thanatophoric dysplasia (TD) was reported earlier in the previous publication. It is one of the most common lethal human skletal dysplasia characterized by severe dwarfism. It occurs in 3 to 4 per 100,000 live births1 and is due to autosomal dominant sporadic de novo mutations in the fibroblast growth factor receptor 3 (FGFR3) gene3 which codes for the FGFR3 transmembrane receptor expressed largely by skeletal and brain tissues in the developing fetus where it is involved with growth regulation. The FGFR3 mutation in TD leads to generalized defects and lack of endochondral ossification, with membranous ossification being less impaired1. Male and female fetuses are equally affected. Two thanatophoric case of this extremely rare occurance are reported and discussed.
  11. Baharudin, A., Din Suhaimi, S., Omar, E.
    MyJurnal
    Schwannomas are benign slow growing lesions arising from the Schwann cells that ensheath the axons of the peripheral, cranial and autonomic nervous systems. Intracranial schwannomas develop from the facial nerve much more rarely than from the vestibular or trigeminal nerves. Ancient schwannoma is an unusual histological variant of this rare disease. A 48 years old man who had recurrent facial nerve paralysis and right external auditory mass is presented in this case report.
  12. Abdul-Wahab, J., Naznin, M, Norlelawati, A.T., Amir Hamzah, A.R.
    MyJurnal
    Transient abnormal myelopoiesis (TAM) occurs in approximately 10% of neonates with Down syndrome. In most cases it resolves spontaneously. Life threatening complications such as cardiopulmonary and liver diseases have been described. We present here two cases which suggest that management of TAM in selected cases will have to be more aggressive.
  13. Ahmad, R., Ishlah, W., Norie A.
    MyJurnal
    The ultimate goal of treatment of glottic malignancy is eradication of the cancer and preservation of maximum function. Ideally this would mean return of normal speech, respiration and deglutition. The foundation of vertical partial laryngectomy (VPL) is based on the knowledge of laryngeal anatomy and an understanding of how cancers invade the larynx. The VPL surgery of the glottic cancer is based on oncological sound principles, which will be further disscussed in this article. For the purpose of description we briefly presented 3 of our cases that underwent vertical partial laryngectomy for glottic cancer.
  14. Adibah, I., Wan Abu Bakar, W.Y., Nik Mohamed Zaki, N.M., Nik Hazlina, N.H., Venkatesh, R.N.
    MyJurnal
    Endometrial stromal sarcoma is a rare tumour of the uterus. We reported a case of a young lady with endometrial stromal sarcoma. She became pregnant while having the disease and delivered a healthy baby, her sixth, without any complication. A total abdominal hysterectomy with bilateral oopherectomy was performed subsequently. She refused any added treatment after the operation. To date, she is free of any recurrence.
  15. Nor Afiah, M.Z., Hejar, A.R., Looi, Y.K., Lim, S.J., Ng, C.Y., Tong, C.Y.
    MyJurnal
    Introduction: Breast cancer is the most common cancer among women worldwide and in Malaysia. It has better cure rate if detected early. However, the practice of breast cancer screening in Malaysia is still low. The objective of this study is to determine the knowledge and its associated factors as well as sources of information on breast cancer and breast cancer screening among female staff in a public university in Malaysia. Materials and Methods: This was a cross sectional study conducted in 2005 involving 394 female staff including academic and non-academic staff, which was selected by cluster sampling. A self-administered questionnaire on socioeconomic characteristics and family history of breast cancer was used for data collection. Chi-square Test and Fisher’s Exact Test was used for testing an association using SPSS 12.0. Results: The response rate was 84.3%. Only 50.9% had high knowledge on breast cancer and breast cancer screening and this was significantly associated with occupational status, monthly family income and educational level (p
  16. Ruchi, K., Anil Kumar, S., Sunil, G., Bashir, A., Prabhat, S.
    MyJurnal
    Introduction: Attention deficit hyperactivity disorder (ADHD) is a frequently encountered clinical condition in children. Based on DSM IV-TR criteria it can be sub-classified into three distinct types namely hyperactiveimpulsive, inattentive and combined. Materials and Methods: In the present study, salivary antioxidant activity (AOA) in children with ADHD was compared with age-matched normal control subjects, both as a whole and also with regard to the three subtypes. Additionally, the effect of therapy on the altered AOA levels was investigated following short term (
  17. al-Khfaji, I.N., Fakhrildin, M.B., Al-Ani, I.M., Mangalo, H.H., Al-Obaidi, S.R.
    MyJurnal
    Introduction: The objective of this study was to investigate the effects of lead on concentration and motility of spermatozoa recovered from epididymis and testes in mature male offspring whose mothers were exposed to different doses and concentrations of lead acetate during gestation period. Materials and Methods: Seventy two healthy mature female mice were divided into three major groups according to the number of injections involving 1, 2 and 3 injections. Each major group was subdivided into four minor groups according to the concentration dose of (0, 25, 50 and 100) mg/Kg of lead acetate. Sperm concentration, percentage of motility and grade of activity were microscopically examined and statistically analyzed. Results: A significant reduction in the sperm functions were seen in relation to an increased in the number of injections and/or concentration of lead acetate dose as compared with the control groups. Conclusion: The toxic effects of lead acetate may interfere with spermatogenesis and metabolism of spermatozoa.
  18. Zalina, N., Aruku, N., Azura, N., Shahida, N., Akhmarina, N., Dian, F.
    MyJurnal
    Introduction: Frequency of lower urinary tract symptoms (LUTS) in young age women is not well studied. It is said to be common among female elderly and multiparous population. The aim of this study is to obtain the prevalence of LUTS among nulliparous students in relation to their personal hygiene. Materials and methods: This is a prospective cross-sectional study conducted among 200 nulliparous medical and nursing students aged between 18-28 years using standardized questionnaires. Urine samples were also collected from students to detect urinary tract infections. Results: The complete data sets of 146 students were analyzed. All of them were nulliparous, single and not sexually active. The prevalence of LUTS was 52.7% consist of over-active bladder, urinary incontinence (UI) and voiding difficulty respectively (51.3%, 34.9% and 45.2%). The most common type of UI was stress urinary incontinence which was 21.9% followed by 11.6% of urgency incontinence. Conclusion: The prevalence of LUTS among young age population is high at 52.7%. Public awareness regarding LUTS and availability of treatment is needed.
  19. Che Badariah, A.A., Asma, H.A., Mohd Nizam, H., Siti, F.A.
    MyJurnal
    Introduction: The aim of this study was to determine the effects of gamat extract on pain behaviour and Fos like immunoreactivity (FLI) expression in the ventral posterolateral thalamus using the acute pain model. Materials & Methods: Fourteen Sprague-Dawley male rats (220-300 gram) were given intraplantar injection of 0.05ml formalin (1%) followed by intraperitoneal administration of either 4 mg/kg gamat extracts (Holothuria spp.) or saline (control). Behavioural changes were observed and rats were sacrificed 2 hours post-formalin injection. Immunohistochemistry testing was done on the brain sections. FLI was examined using a light microscope attached to an image analyser. The behaviour and FLI data were analysed using repeated measure analysis of variance and independent t-test respectively. Significance level was taken as p
  20. Zamzuri Z, Goh KL, Aminuddin CA, Mohamed Azril MA, Shukrimi A
    MyJurnal
    A 15-year–old Malay male with congenital insensitivity to pain presented with recurrent septic arthritis of the left knee complicated by osteomylitis. Repeated arthrotomy and wound debridement was done, however, the condition was not resolved. Amputation was suggested as the best method of treatment to eradicate the infection.
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