Displaying publications 101 - 120 of 12295 in total

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  1. Muniandy G, Kamaruzaman L, Jan TH, Mohd R, Neesam MT, Fong Voon K, et al.
    Acta Med Indones, 2023 Jan;55(1):78-82.
    PMID: 36999269
    Cefepime is a frequently used fourth-generation cephalosporin antibiotic for a wide variety of infections. Toxic levels of this drug can cause neurological complications. The most common neurological adverse event of cefepime is headache and lightheadedness. Here, we presented a case of cefepime induced encephalopathy in a 57-year-old female patient with acute on chronic kidney disease. With an accurate diagnosis that requires a high index of clinical suspicion, prompt management was instituted. She had full resolution of symptoms following discontinuation of the medication and also emergent dialysis.
    Matched MeSH terms: Middle Aged
  2. Akhavan Hejazi SM, Mazlan M
    Acta Med Iran, 2012;50(4):292-4.
    PMID: 22592581
    Post-stroke shoulder pain is associated with either a peripheral or central pathology. However, most of the time, it is challenging to establish a cause-and-effect relationship between the suggested pathology and shoulder pain reported. We report a 66 year-old man who developed a right hemiplegic shoulder pain two months post stroke with initial investigations suggestive of peripheral pathologies. Pharmacological and non-pharmacological treatment did not improve his shoulder pain. Later he developed complex regional pain syndrome (CRPS) of the right hand and the initial shoulder pain subsequently relieved following resolution of the CRPS.
    Matched MeSH terms: Aged
  3. Mohandas Rao KG, Somayaji SN, Ashwini LS, Ravindra S, Abhinitha P, Rao A, et al.
    Acta Med Iran, 2012;50(8):572-6.
    PMID: 23109033
    Variations in the origin of axillary artery branches are common. But, distinctly abnormal course of its posterior circumflex humeral branch is rare. We are reporting a case of posterior circumflex humeral artery (PCHA) originating from the axillary artery, passing through lower triangular space to reach the scapular region where it accompanied the axillary nerve and posterior circumflex humeral vein to pass around surgical neck of humerus, deep to the fibers of deltoid. Other variations observed in this specimen were the radial collateral artery arising from the PCHA, middle collateral artery arising directly from the brachial artery and absence of profunda brachii artery. PCHA forming a hair pin loop, traversing through lower triangular space instead of quadrangular space taking a long course is being reported for the first time. Further, the clinical and surgical importance of this case especially in relation with quadrangular space syndrome and relevant literature is discussed.
    Matched MeSH terms: Middle Aged
  4. Hussaini J, Mutusamy S, Omar R, Rajagopalan R, Narayanan P
    Acta Med Iran, 2012;50(2):151-2.
    PMID: 22359087
    We report a rare case of base of tongue tuberculosis following pulmonary tuberculosis. Patient presented to us with chief complaints of sore throat and pain on swallowing for period of 3 months. On examination with 70 degree telescope, we observed an ulcer on right side of base of tongue. The edges of the ulcer appeared to be undermined with whitish slough at the centre of the ulcer. Examination of neck showed a multiple small palpable middle deep cervical lymph nodes on right side of neck. Biopsy of the ulcer was taken, which showed granulomatous inflammation, suggestive of tuberculosis. Laboratory investigations revealed a raise in erythrocyte sedimentation rate, sputum for acid fast bacilli was strongly positive. Chest X ray was performed for patient showed multiple areas of consolidation. Patient was referred to chest clinic for further management of tuberculosis and was started on anti-tuberculous drugs. In conclusion tuberculosis of oral cavity is rare, but should be considered among one of the differential diagnosis of the oral lesions and biopsy is necessary to confirm the diagnosis.
    Matched MeSH terms: Middle Aged
  5. 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.
    Matched MeSH terms: Aged
  6. Sazliyana Shaharir S, Jamil A, Kosasih S, Soo Fin L, Sridharan R, Hayati Md Pauzi S
    Acta Med Iran, 2017 Dec;55(12):800-806.
    PMID: 29373888
    A 59-year-old man presented with proximal myopathy, myalgia, and weight loss, with the initial markedly elevated serum creatine kinase at 11,000 U/L. Due to his refusal for muscle biopsy, he was initially treated as inflammatory myositis and responded well with the corticosteroids. However, he subsequently had a relapse of the symptoms with more extensive systemic involvement, i.e., hypercalcemia, lymphadenopathy and subcutaneous nodules. Finally, a biopsy of the thigh and subcutaneous nodule revealed non-caseating granulomatous inflammation, consistent with sarcoidosis. He responded well to the corticosteroids, and finally, azathioprine was added as a steroid-sparing agent. Including our series, there are 103 cases of symptomatic muscle involvement in sarcoidosis patients published in the English literature to date. Further pool analysis of the cases will be reported in this review.
    Matched MeSH terms: Middle Aged
  7. Ali O, Muda K, Khalid B
    Acta Med. Okayama, 1994 Dec;48(6):289-92.
    PMID: 7709757
    A study was conducted to compare the urinary iodine concentrations in populations from Pahang, Central Malaysia, with those in the capital city Kuala Lumpur, and to compare those of Malays from villages at Batu Talam, Batu Malim, FELDA Sungai Koyan and Hulu Sungai with neighboring aboriginal settlements at Lanai and Buntu. Two hundred and forty urine samples were collected randomly among the population (male 1 1 1 and female 129). The urinary iodine concentrations, measured by the ashing method, among Malays were as follows: Batu Talam 1.1-7.6 micrograms/dl, Batu Malim 1.4-6.6 micrograms/dl, FELDA Sungai Koyan 0.5-6.9 micrograms/dl and Hulu Sungai 0.6-9.9 micrograms/dl. Among aborigines, the urinary iodine levels were 0.1-2.9 micrograms/dl in Lanai and 1.7-6.5 micrograms/dl in Buntu. There was a significant difference in the levels of urinary iodine with regard to gender, but not regarding age. The aborigines had significantly lower iodine levels than Malays (P < 0.001). This difference was also significant with regard to location. The urinary iodine content in Kuala Lumpur was the highest and that in the aboriginal Lanai village was the lowest. Thus, the study showed that the levels of iodine in the urine were influenced by ethnicity and geographic location.
    Matched MeSH terms: Aged; Middle Aged
  8. Idris Z, Muzaimi M, Hussin S, Mahmood WH, Abdullah WZ
    Acta Neurochir (Wien), 2012 May;154(5):887-93; discussion 893-4.
    PMID: 22362049 DOI: 10.1007/s00701-012-1296-2
    Coagulation factor XIII and other haemostatic markers are known strengthen fibrin clot formation and, hence, may facilitate safer surgery. Currently however, factor XIII activity levels are not routinely screen. Therefore, the purpose of this study was to determine the association of perioperative factor XIII activity levels and other haemostatic markers with postoperative intracranial haematoma formation in neurosurgical patients.
    Matched MeSH terms: Aged; Middle Aged
  9. Azian AA, Nurulazman AA, Shuaib L, Mahayidin M, Ariff AR, Naing NN, et al.
    Acta Neurochir (Wien), 2001;143(7):711-20.
    PMID: 11534693
    Head injury is a significant economic, social and medical problem all over the world. Road accidents are the most frequent cause of head injury in Malaysia with highest risk in the young (15 to 24 years old). The associated outcomes include good recovery, possibility of death for the severely injured, which may cause disruption of the lives of their family members. It is important to predict the outcome as it will provide sound information to assist clinicians in Malaysia in providing prognostic information to patients and their families, to assess the effectiveness of different modes of treatment in promoting recovery and to document the significance of head injury as a public health problem.

    RESULTS: A total of 103 cases with intracranial haemorrhage i.e. intracerebral haemorrhage, extradural haemorrhage, subdural haemorrhage, intraventricular haemorrhage, haemorrhagic contusion and subarachnoid haemorrhage, following motor vehicle accidents was undertaken to study factors contributing to either good or poor outcome according to the Glasgow Outcome Scale. Patients below 12 years of age were excluded. The end point of the study was taken at 24 months post injury. The selected variables were incorporated into models generated by logistic regression techniques of multivariate analysis to see the significant predictors of outcome as well as the correlation between the CT findings with GCS.

    CONCLUSION: Significant predictors of outcome were GCS on arrival in the accident emergency department, pupillary reflex and the CT scan findings. The CT predictors of outcome include ICH, EDH, IVH, present of SAH, site of ICH, volumes of EDH and SDH as well as midline shift.

    Matched MeSH terms: Aged; Middle Aged
  10. Zakaria Z, Sapiai NA, Ghani ARI
    Acta Neurochir (Wien), 2021 08;163(8):2359-2362.
    PMID: 34101024 DOI: 10.1007/s00701-021-04860-w
    The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as coronavirus disease 2019 (COVID-19) is a highly transmissible virus and has become pandemic. Part of the prevention of disease spread by the Malaysian government is by getting COVID-19 vaccine. Using the mRNA technology, the Pfizer/BioNTech vaccine is one of the vaccines been approved by the Drug Control Authority in Malaysia. Herein, we report an immediate complication of cerebral VST after the first dose of the Pfizer/BioNTech vaccine.
    Matched MeSH terms: Middle Aged
  11. Abdullah JM, Husin A
    Acta Neurochir. Suppl., 2011;111:421-4.
    PMID: 21725794 DOI: 10.1007/978-3-7091-0693-8_72
    The use of intravascular hypothermia in the treatment of hemorrhagic stroke is currently still being researched. The exact therapeutic properties and effect of hypothermia on the natural progression of the disease are not known, and a only small number of papers has been published with results from these studies. Mild hypothermia at 34°C was induced in six patients with hemorrhagic stroke in the first 48 h after presentation, using an intravascular catheter placed in the inferior vena cava. The hypothermia was induced and maintained for 24 h followed by gradual rewarming. Another 18 patients with hemorrhagic stroke but not receiving hypothermia were then taken as the control group, and all patients were treated with standard stroke management. The patients were then followed up using the modified Rankin Scale (mRS) for 6 months and 1 year. There was a statistically significant improvement at 6 months and 1 year follow-up using the mRS score in the hypothermia group, indicating a possible beneficial effect of early therapeutic hypothermia in the management of acute hemorrhagic stroke. However, a larger study is needed in order to confirm our finding.
    Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged
  12. Keong LH, Ghani AR, Awang MS, Sayuthi S, Idris B, Abdullah JM
    Acta Neurochir. Suppl., 2011;111:375-9.
    PMID: 21725785 DOI: 10.1007/978-3-7091-0693-8_63
    The aim of the study was to determine the prognostic value of a high augmentation index, which was a surrogate marker of arterial stiffness in patients with spontaneous intracerebral hemorrhage. The outcome was divided into two groups in which the following data were collected in a computer running SphygmoCor CvMS software version 8.2. Logistic regression analysis was carried out among significant variables to identify an independent predictor of 6-month outcome and mortality. Sixty patients were recruited into the study. Admission Glasgow Coma Scale score (OR, 0.7; 95% CI, 0.450-0.971; P=0.035), total white cell count (OR, 1.2; 95% CI, 1.028-1.453; P=0.023) and hematoma volume (OR, 1.1; 95% CI, 1.024-1.204; P=0.011) were found to be statistically significant for identifying poor 6-month outcome in multivariate analysis. Factors independently associated with mortality were a high augmentation index (OR, 8.6; 95% CI, 1.794-40.940; P=0.007) and midline shift (OR, 7.5; 95% CI, 1.809-31.004; P=0.005). Admission Glasgow Coma Scale score, total white cell count and hematoma volume were significant predictors for poor 6-month outcome, and a high augmentation index and midline shift were predictors for 6-month mortality in this study.
    Matched MeSH terms: Aged; Middle Aged
  13. Dang YL, Hor JY, Chia YK, Lim TT, Eow GB
    Acta Neurol Belg, 2014 Sep;114(3):239-41.
    PMID: 23757110 DOI: 10.1007/s13760-013-0217-3
    Matched MeSH terms: Middle Aged
  14. Tran AT, Nguyen HA, Vu DL, Pham MT, Tran C, Le HK, et al.
    Acta Neurol Belg, 2020 Feb;120(1):99-105.
    PMID: 31679149 DOI: 10.1007/s13760-019-01223-2
    Mechanical thrombectomy (MT) has been demonstrated as an effective treatment for acute ischemic stroke (AIS), thanks to large vessel occlusion (LVO), especially in case of anterior cerebral artery with many randomized clinical trials (RCTs) every year. On the other hand, there is a limited number of basilar artery occlusion (BAO)-related studies which have been conducted. The fact prompts our range of case studies, which furnish BAO understanding with our experience, results and some prognosis factors of MT. This retrospective and single-center study was conducted on 22 patients who were diagnosed with BAO and underwent the treatment of MT from October 2012 to January 2018. Clinical feature such as radiological imaging, procedure complications, and intracranial hemorrhage were all documented and evaluated. All the studies' results based on performance using modified Rankin scale score (mRS) and mortality at 90 days. The results from these BAO patients study indicated that the posterior circulation Acute Stroke Prognosis Early CT Score (pcASPECTS) recorded before the intervention was 7.7 ± 1.6, while the admission National Institutes of Health Stroke Scale (NIHSS) was 17.5 ± 5.4. 15/22 cases achieved successful recanalization (TICI, Thrombolysis in Cerebral Infarction scale, of 2b-3), accounting for 68.2%. The results highlighted 50% of the favorable outcome (mRS 0-2) occupying 11 out of 22 patients in total and the overall mortality was 36.4%. The intracranial hemorrhagic complication was detected in three cases (13.6%). Placing in juxtaposition the poor-outcome group and the favorable-outcome group, we could witness statistically significant difference (P 
    Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged
  15. Pratap-Chand R, Sinniah M, Salem FA
    Acta Neurol. Scand., 1988 Sep;78(3):185-9.
    PMID: 3227804
    Cognitive impairment has been reported to occur in minor head injury (concussion). The value of the P300 evoked potential as a measure of cerebral concussion was studied in 20 patients with minor head injury and compared with the data from 20 normal subjects. Significant abnormalities of the P300 latency and amplitude were noted in these patients in the post-concussion period. The abnormalities improved completely on repeat testing. The correlation of the P300 to other parameters of head injury is discussed. The P300 constitutes a simple laboratory test that is sensitive measure of cerebral dysfunction in concussive head injuries.
    Matched MeSH terms: Middle Aged
  16. Tsai JJ, Wu T, Leung H, Desudchit T, Tiamkao S, Lim KS, et al.
    Acta Neurol. Scand., 2018 Apr;137(4):378-391.
    PMID: 29214650 DOI: 10.1111/ane.12879
    Epileptic seizures are refractory to treatment in approximately one-third of patients despite the recent introduction of many newer antiepileptic drugs (AEDs). Development of novel AEDs therefore remains a high priority. Perampanel is a first-in-class non-competitive selective AMPA receptor antagonist with a unique mechanism of action. Clinical efficacy and safety of perampanel as adjunctive treatment for focal seizures with/without secondary generalization (±SG) and primary generalized tonic-clonic (PGTC) seizures have been established in five phase 3 randomized controlled trials (RCTs), and a long-term extension study, and perampanel is approved as monotherapy for focal seizures ±SG in the USA. In patients with focal seizures ±SG, add-on perampanel resulted in median percent reduction in seizure frequency 23.3%-34.5% and ≥50% responder rate 28.5%-37.6%; in PGTC seizures, these results were 76.5% and 64.2%, respectively. Efficacy among adolescents (reduction in seizure frequency 34.8%-35.6%; ≥50% responder rate 40.9%-45.0%) and elderly people (reduction in seizure frequency 12.5%-16.9%; ≥50% responder rate 22.2%-42.9%) is similar to those in adults, and results remain comparable between Asian (reduction in seizure frequency 17.3%-38.0%) and global populations. Perampanel has been extensively studied in real-world clinical practice, with similar efficacy and safety results to the RCTs (≥50% responder rate 12.8%-75.0%; adverse events of somnolence/sedation, dizziness, ataxia, and behavioral changes). Real-world observational studies suggest that perampanel tolerability can be improved by slow titration (2 mg every 2-4 weeks), and bedtime administration can mitigate somnolence and dizziness. Counseling about the potential for behavioral changes and close monitoring are recommended.
    Matched MeSH terms: Aged
  17. Sii HL, Ng SH, Wong VF, Law WC
    Acta Neurol Taiwan, 2023 Dec 30;32(4):207-211.
    PMID: 37723913
    PURPOSE: Guillain-Barré Syndrome (GBS) associated with SARS-CoV-2 vaccine administration is very rare. Early recognition of GBS at early stage could prevent extensive nerve damage with potential respiratory and autonomic failure.

    CASE REPORT: We report a case of paraparetic spectrum of GBS in a 53-year-old lady who presented with rapidly progressive acute flaccid paralysis involving both lower extremities with areflexia eight days after the first dose of Sinovac vaccine for SARS-CoV-2 in Malaysia. Cerebrospinal fluid (CSF) albuminocytological dissociation was seen and nerve conduction study (NCS) revealed sensory neuropathy. The diagnosis of GBS was made based on the Brighton criteria. Patient responded well to intravenous immunoglobulin (IVIG).

    CONCLUSION: Though there is currently no convincing evidence of any causation between GBS and SARS- CoV-2 vaccination, clinicians should remain vigilant and consider GBS in the differential diagnosis for patient who presents with weakness with reduced or absent deep tendon reflex after vaccination against SARS-CoV-2.

    Matched MeSH terms: Middle Aged
  18. Shafiee MN, Mongan N, Seedhouse C, Chapman C, Deen S, Abu J, et al.
    Acta Obstet Gynecol Scand, 2017 May;96(5):556-562.
    PMID: 28176325 DOI: 10.1111/aogs.13106
    INTRODUCTION: Women with polycystic ovary syndrome have a three-fold higher risk of endometrial cancer. Insulin resistance and hyperlipidemia may be pertinent factors in the pathogenesis of both conditions. The aim of this study was to investigate endometrial sterol regulatory element binding protein-1 gene expression in polycystic ovary syndrome and endometrial cancer endometrium, and to correlate endometrial sterol regulatory element binding protein-1 gene expression with serum lipid profiles.

    MATERIAL AND METHODS: A cross-sectional study was performed at Nottingham University Hospital, UK. A total of 102 women (polycystic ovary syndrome, endometrial cancer and controls; 34 participants in each group) were recruited. Clinical and biochemical assessments were performed before endometrial biopsies were obtained from all participants. Taqman real-time polymerase chain reaction for endometrial sterol regulatory element binding protein-1 gene and its systemic protein expression were analyzed.

    RESULTS: The body mass indices of women with polycystic ovary syndrome (29.28 ± 2.91 kg/m(2) ) and controls (28.58 ± 2.62 kg/m(2) ) were not significantly different. Women with endometrial cancer had a higher mean body mass index (32.22 ± 5.70 kg/m(2) ). Sterol regulatory element binding protein-1 gene expression was significantly increased in polycystic ovary syndrome and endometrial cancer endometrium compared with controls (p 

    Matched MeSH terms: Middle Aged
  19. Sen DK, Sivanesaratnam V, Chuah CY, Ch'ng SL, Singh J, Paramsothy M
    Acta Obstet Gynecol Scand, 1987;66(5):425-8.
    PMID: 3425244
    Of 36 cases of choriocarcinoma treated at the University Hospital Kuala Lumpur during 1980-84 inclusive, 6 patients were found to have cerebral metastases. Intrathecal methotrexate and combination chemotherapy were started in all cases, with monitoring of tumor growth by serial beta-HCG assays and CT scanning of brain and lung. Chemotherapy was reduced because of severe toxicity in 2 patients, one of whom received radiotherapy to the brain. Four patients (66%) have now been in remission for 2.5-6 years. Two did not respond to therapy and died. The factors involved in therapy and response are discussed.
    Matched MeSH terms: Middle Aged
  20. Trutnovsky G, Kamisan Atan I, Ulrich D, Martin A, Dietz HP
    Acta Obstet Gynecol Scand, 2016 Dec;95(12):1411-1417.
    PMID: 27622984 DOI: 10.1111/aogs.13018
    INTRODUCTION: The study aimed to analyze the relation between the degree of puborectalis muscle trauma and subjective symptoms and objective findings of pelvic organ prolapse (POP), comparing two continuous scoring systems with a discrete scoring system for translabial ultrasound imaging.

    MATERIAL AND METHODS: In this retrospective observational study the records of patients attending a tertiary urogynecological unit between January 2012 and December 2014 were analyzed. POP assessment included a standardized interview, clinical examination using Pelvic Organ Prolapse Quantification and four-dimensional translabial ultrasound. Puborectalis muscle trauma was assessed with tomographic ultrasound imaging using two continuous scoring systems and a previously established discrete system. Receiver operating characteristics and adjusted odds ratios were used for comparison of scoring systems in predicting symptoms and signs of POP.

    RESULTS: Of 1258 women analyzed, 52.6% complained of prolapse symptoms. On ultrasound imaging, 65.7% of women had sonographically significant POP. Complete avulsion was diagnosed in 25.3% of women, being unilateral in 13.9% and bilateral in 11.4%. A maximum score in the 6-point and the 12-point tomographic ultrasound imaging scale increased the odds for a diagnosis of any significant POP on ultrasound by 4.4 and 4.8 times, respectively, compared with 4.6 times for the discrete diagnosis of bilateral avulsion. For all avulsion scoring systems the relation was strongest for cystocele and uterine prolapse.

    CONCLUSIONS: A continuous avulsion scoring system based on tomographic findings does not provide superior performance for the prediction of subjective symptoms and objective findings of prolapse compared with a discrete diagnostic system of unilateral or bilateral avulsion.

    Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged
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