MyMedR

Transient blindness in pregnancy induced hypertension

Achanna S, Monga D, Sivagnanam

Asia Oceania J Obstet Gynaecol, 1994 Mar;20(1):49-52.

Sudden blindness in pregnancy is a devastating experience for the patient, her family and the treating obstetrician. Four cases of cortical blindness with pregnancy induced hypertension are presented, seen at the General Hospital Kota Bharu, Kelantan, in 1990. The incidence at the GHKB was 1: 1559 (4 cases out of 6,237 deliveries) which is higher as compared to neighbouring Singapore. The pathophysiology of this condition is still not well understood, though it is hoped that newer sophisticated imaging techniques like magnetic resonance imaging (MRI), CT scan, and blood flow waveform analysis by Doppler ultrasound will throw some light on the subject. Two of our cases presented with antepartum and two with postpartum cortical blindness. Therefore, termination of pregnancy alone may not provide the solution to this therapeutic dilemma.

Matched MeSH terms: Prognosis

Fulltext Complete heart block in Malaysians

Chin K, Singham KT, Masduki A

Med J Malaysia, 1983 Jun;38(2):142-4.

PMID: 6621444

Matched MeSH terms: Prognosis

Fulltext Traumatic dislocation of the knee

Dhillon KS, Teng TK

Med J Malaysia, 1987 Sep;42(3):173-6.

PMID: 3506639

This study analyses retrospectively the results of sixteen acute dislocations of the knee at the University Hospital, Kuala Lumpur from 1980 to 1985. The average follow-up was 3.5 years. There were seven posterior, six anterior, one lateral and two postero-lateral dislocations. All were due to motor vehicle accidents except one. There were four patients with popliteal artery injury and two patients with peroneal nerve injury; three required amputations due to late detection. All the peroneal nerve palsies were permanent. The results of surgical treatment appear to be better than conservative management of acute dislocation of the knee.

Matched MeSH terms: Prognosis

Eclampsia - a review of 48 cases

Ong SK, Foo J, Wong WP, Yusof K

Med J Malaysia, 1978 Mar;32(3):206-11.

PMID: 683043

Matched MeSH terms: Prognosis

Fulltext Alcohol-induced psychotic disorder with suicidal attempt: a case report

Tengku Mohd Saifuddin, Chong Wei Wei, Aida Farina Ismail, Noorul Amilin Harun

Malaysian Journal of Psychiatry, 2018;27(1):0-0.

MyJurnal

Alcohol-induced psychotic disorder (AIPD) is a rare complication of alcohol
abuse which is characterized by an acute onset of auditory or visual
hallucinations that occur either during or after a period of heavy alcohol
consumption. Other symptoms include delusions, thought disorder,
psychomotor disturbances, and abnormal affect. To establish the diagnosis,
one must rule out other disorders such as alcohol withdrawal delirium or
other psychotic disorders. Although it is well recognised, relatively little is
known about the condition. Moreover, the pathogenesis and treatment of
AIPD are still unclear despite high co-morbidity with other psychiatric
disorders, high re-hospitalization as well as mortality rates and suicidal
behaviour. Therefore, the prognosis appears less favourable. We present a
case of young man with AIPD with suicidal attempt secondary to auditory
hallucination.

Matched MeSH terms: Prognosis

Fulltext Transient Behavior in Variable Geometry Industrial Gas Turbines: A Comprehensive Overview of Pertinent Modeling Techniques

Hashmi MB, Lemma TA, Ahsan S, Rahman S

Entropy (Basel), 2021 Feb 22;23(2).

PMID: 33671488 DOI: 10.3390/e23020250

Generally, industrial gas turbines (IGT) face transient behavior during start-up, load change, shutdown and variations in ambient conditions. These transient conditions shift engine thermal equilibrium from one steady state to another steady state. In turn, various aero-thermal and mechanical stresses are developed that are adverse for engine's reliability, availability, and overall health. The transient behavior needs to be accurately predicted since it is highly related to low cycle fatigue and early failures, especially in the hot regions of the gas turbine. In the present paper, several critical aspects related to transient behavior and its modeling are reviewed and studied from the point of view of identifying potential research gaps within the context of fault detection and diagnostics (FDD) under dynamic conditions. Among the considered topics are, (i) general transient regimes and pertinent model formulation techniques, (ii) control mechanism for part-load operation, (iii) developing a database of variable geometry inlet guide vanes (VIGVs) and variable bleed valves (VBVs) schedules along with selection framework, and (iv) data compilation of shaft's polar moment of inertia for different types of engine's configurations. This comprehensive literature document, considering all the aspects of transient behavior and its associated modeling techniques will serve as an anchor point for the future researchers, gas turbine operators and design engineers for effective prognostics, FDD and predictive condition monitoring for variable geometry IGT.

Matched MeSH terms: Prognosis

Fulltext Metastatic Thymic Carcinoma on Restaging 18F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography

Hoe Khoo AC, Ang SF

Indian J Nucl Med, 2020 10 21;35(4):364-366.

PMID: 33642772 DOI: 10.4103/ijnm.IJNM_123_20

Thymic carcinoma is a rare thymic epithelial cancer which is not only locally invasive but also highly aggressive disease. The prognosis for this cancer is poor and the surgery remains the mainstay of treatment. Thymic carcinomas have been shown to metastasize to the lymph nodes, lung, and liver. A 63-year old male who was successfully treated for thymic cancer in 2015, presented with metastatic disease recurrence to the spinal cord. We share interesting images of the spinal cord lesions as well as pituitary metastases that were incidentally detected on restaging 18F-fluorodeoxyglucose positron emission tomography-computed tomography.

Matched MeSH terms: Prognosis

Fulltext Colorectal Cancer Immunotherapy: Options and Strategies

Johdi NA, Sukor NF

Front Immunol, 2020;11:1624.

PMID: 33042104 DOI: 10.3389/fimmu.2020.01624

Colorectal cancer is the third most common cancer in the world with increasing incidence and mortality rates globally. Standard treatments for colorectal cancer have always been surgery, chemotherapy and radiotherapy which may be used in combination to treat patients. However, these treatments have many side effects due to their non-specificity and cytotoxicity toward any cells including normal cells that are growing and dividing. Furthermore, many patients succumb to relapse even after a series of treatments. Thus, it is crucial to have more alternative and effective treatments to treat CRC patients. Immunotherapy is one of the new alternatives in cancer treatment. The strategy is to utilize patients' own immune systems in combating the cancer cells. Cancer immunotherapy overcomes the issue of specificity which is the major problem in chemotherapy and radiotherapy. The normal cells with no cancer antigens are not affected. The outcomes of some cancer immunotherapy have been astonishing in some cases, but some which rely on the status of patients' own immune systems are not. Those patients who responded well to cancer immunotherapy have a better prognostic and better quality of life.

Matched MeSH terms: Prognosis

Oesophageal hepatoid carcinoma with liver metastasis, a diagnostic dilemma

Yahaya A, Wa Kammal WS, Abd Shukor N, Osman SS

Malays J Pathol, 2019 Apr;41(1):59-63.

PMID: 31025640

Alpha-fetoprotein (AFP)-producing carcinoma which microscopically mimics hepatocellular carcinoma (HCC) is a rare entity known as hepatoid adenocarcinoma (HC). They usually arise in the stomach, while oesophageal origin is only occasionally encountered. This tumour is highly aggressive and is associated with a poor prognosis. They frequently metastasise to the liver, thus giving rise to diagnostic difficulty, especially in cases where simultaneous oesophageal and liver mass are present. We reported a case of oesophageal hepatoid carcinoma with multiple liver metastasis, that was associated with an increased serum AFP. The distinction between HCC and HC is important because HC is more aggressive and has a poorer prognosis with limited therapeutic options. An extensive diagnostic work-up which include a thorough clinical history, radiological investigations (computed tomography or magnetic resonance imaging) as well as tissue biopsy supported by a panel of immunohistochemical markers are necessary to aid in the diagnosis of HC.

Matched MeSH terms: Prognosis

Fulltext A comprehensive overview of mitochondrial DNA 4977-bp deletion in cancer studies

Yusoff AAM, Abdullah WSW, Khair SZNM, Radzak SMA

Oncol Rev, 2019 Jan 14;13(1):409.

PMID: 31044027 DOI: 10.4081/oncol.2019.409

Mitochondria are cellular machines essential for energy production. The biogenesis of mitochondria is a highly complex and it depends on the coordination of the nuclear and mitochondrial genome. Mitochondrial DNA (mtDNA) mutations and deletions are suspected to be associated with carcinogenesis. The most described mtDNA deletion in various human cancers is called the 4977-bp common deletion (mDNA4977) and it has been explored since two decades. In spite of that, its implication in carcinogenesis still unknown and its predictive and prognostic impact remains controversial. This review article provides an overview of some of the cellular and molecular mechanisms underlying mDNA4977 formation and a detailed summary about mDNA4977 reported in various types of cancers. The current knowledges of mDNA4977 as a prognostic and predictive marker are also discussed.

Matched MeSH terms: Prognosis

Fulltext Kimura disease: a differential diagnosis in a nephrotic child

Aziz, A., Mohamad, I., Zawawi, N.

Malaysian Family Physician, 2018;13(2):32-35.

MyJurnal

Kimura disease presents as benign lesion and is commonly present among the Asian population. It
is a disease with a favourable prognosis and a peak age of onset in the third decade. It is a chronic
inflammatory disorder of unknown etiology that involves the lymph nodes and subcutaneous
tissues of the head and neck region. We report a case of a 15-year-old boy with multiple Kimura
lymphadenopathies involving the left posterior auricular region as well as the anterior and posterior
triangles of the neck.

Matched MeSH terms: Prognosis

Clinical interpretation of findings from a systematic review and a comprehensive meta-analysis on clinicopathological and prognostic characteristics of oral squamous cell carcinomas (OSCC) arising in patients with oral lichen planus (OLP)

Jayaraj R, Shetty SS, Kumaraswamy C, Gothandam KM, Ram MR, Shaw P

Oral Oncol, 2020 09;108:104974.

PMID: 32798186 DOI: 10.1016/j.oraloncology.2020.104974

Matched MeSH terms: Prognosis

Fulltext Gonadotropin-releasing hormone stimulation test and diagnostic cutoff in precocious puberty: a mini review

Ab Rahim SN, Omar J, Tuan Ismail TS

Ann Pediatr Endocrinol Metab, 2020 Sep;25(3):152-155.

PMID: 32871650 DOI: 10.6065/apem.2040004.002

The gonadotropin-releasing hormone (GnRH) stimulation test is a valuable tool in diagnosing and differentiating causes of early pubertal occurrences. Utility of the test can be limited in some instances, however, including the early phases of pubertal hypothalamic-pituitary-gonadal axis activation, in girls showing commonly overlapping pictures, and in obese children due to excess circulating estrogen that suppresses luteinizing hormone (LH). A lack of consistent baseline and stimulated gonadotropin cutoffs observed in different studies also contributes to limitations in testing. Nevertheless, early detection of true pathological causes for pubertal disorders is needed to allow prompt treatment and better prognosis. While basal LH can be beneficial as a good screening tool for detecting pubertal disorder, it does not preclude the need for GnRH testing. The aim of this review was to highlight the role of GnRH stimulation tests and varying testing cutoffs in diagnosis of precocious puberty and its classification.

Matched MeSH terms: Prognosis

Impact of metabolic risk factors on the severity and outcome of patients with alcohol-associated acute-on-chronic liver failure

Duseja A, De A, Taneja S, Choudhury AK, Devarbhavi H, Hu J, et al.

Liver Int, 2021 01;41(1):150-157.

PMID: 32970356 DOI: 10.1111/liv.14671

BACKGROUND: Metabolic risk factors may impact the severity and outcome of alcoholic liver disease. The present study evaluated this effect in patients with alcohol-associated acute-on-chronic liver failure (ACLF).

METHODOLOGY: One thousand two hundred and sixteen prospectively enrolled patients with ACLF (males 98%, mean age 42.5 ± 9.4 years, mean CTP, MELD and AARC scores of 12 ± 1.4, 29.7 ± 7 and 9.8 ± 2 respectively) from the Asian Pacific Association for the Study of the Liver (APASL) ACLF Research Consortium (AARC) database were analysed retrospectively. Patients with or without metabolic risk factors were compared for severity (CTP, MELD, AARC scores) and day 30 and 90 mortality. Information on overweight/obesity, type 2 diabetes mellitus (T2DM), hypertension and dyslipidaemia were available in 1028 (85%), 1019 (84%), 1017 (84%) and 965 (79%) patients respectively.

RESULTS: Overall, 392 (32%) patients died at day 30 and 528 (43%) at day 90. Overweight/obesity, T2DM, hypertension and dyslipidaemia were present in 154 (15%), 142 (14%), 66 (7%) and 141 (15%) patients, respectively, with no risk factors in 809 (67%) patients. Patients with overweight/obesity had higher MELD scores (30.6 ± 7.1 vs 29.2 ± 6.9, P = .007) and those with dyslipidaemia had higher AARC scores (10.4 ± 1.2 vs 9.8 ± 2, P = .014). Overweight/obesity was associated with increased day 30 mortality (HR 1.54, 95% CI 1.06-2.24, P = .023). None of other metabolic risk factors, alone or in combination, had any impact on disease severity or mortality. On multivariate analysis, overweight or obesity was significantly associated with 30-day mortality (aHR 1.91, 95% CI 1.41-2.59, P

Matched MeSH terms: Prognosis

Fulltext Clinical management of chronic mercury intoxication secondary to skin lightening products: A proposed algorithm

Ramli FF

Bosn J Basic Med Sci, 2021 Jun 01;21(3):261-269.

PMID: 32415819 DOI: 10.17305/bjbms.2020.4759

Mercury is a toxic substance that is commonly used in skin lightening products. Various effects on humans have been observed, which affect both users and non-users. Many studies reported delayed diagnosis and treatment, even after weeks of hospitalization. The possible reasons are non-specific clinical manifestation and lack of awareness and knowledge regarding chronic mercury intoxication secondary to skin lightening products. A thorough history of mercury exposure is crucial. Physical assessment and relevant supporting tests are indicated to establish a diagnosis. Blood and urine mercury levels are an essential examination for diagnosis and monitoring of the progress and response to treatment. The primary treatment is the discontinuation of the skin lightening products. Chelation therapy is not mandatory and is usually indicated for symptomatic patients. The prognosis depends on the duration of the product use, concentration of mercury in the skin product, and the severity of clinical presentation.

Matched MeSH terms: Prognosis

Fulltext Optic neuritis in a child with biotinidase deficiency: case report and literature review

Hayati AA, Wan-Hitam WH, Cheong MT, Yunus R, Shatriah I

Clin Ophthalmol, 2012;6:389-95.

PMID: 22457589 DOI: 10.2147/OPTH.S29048

Optic atrophy has often been reported in children with biotinidase deficiency. The visual prognosis is usually poor. This report is of a 6-year-old boy with an early onset of biotinidase deficiency who presented with acute profound visual loss in both eyes. Fundoscopy revealed swollen discs in both eyes, and the imaging was consistent with bilateral optic neuritis. He was treated with systemic corticosteroid, and commenced on oral biotin. The final visual outcome was promising.

Matched MeSH terms: Prognosis

Natural history and clinical features of ALS in Malaysia

Abdul Aziz NA, Toh TH, Goh KJ, Loh EC, Capelle DP, Abdul Latif L, et al.

Amyotroph Lateral Scler Frontotemporal Degener, 2021 02;22(1-2):108-116.

PMID: 33084408 DOI: 10.1080/21678421.2020.1832121

OBJECTIVE: Studies from multiethnic populations are rarely reported but do indicate differences in phenotypic presentation and survival in amyotrophic lateral sclerosis (ALS). In this study, we aimed to investigate the natural history of a cohort of ALS patients from a multiethnic population. Methods: Data from ALS patients presenting to our multidisciplinary ALS clinic were prospectively collected from January 2015 to June 2020 as part of an ongoing hospital-based patient registry. Kaplan-Meier and Cox regression model were performed to identify potential prognostic factors. Results: A total of 144 ALS patients were recruited. We estimated the crude ALS incidence as 0.53 per 100,000 for 2019 but rises to 2 per 100,000 in patients aged 60-74 years. The majority of patients were of Chinese ethnicity (59.7%), followed by Malay (24.3%), Indian (11.1%), and others (4.9%). Malaysian Indians had a significantly steeper ALSFRS-R slope at diagnosis (p = 0.040). We found a worse prognosis in patients with bulbar-onset (HR = 1.915, p = 0.019), older age (HR = 1.052, p = 0.000), and who were fast-progressors (HR = 1.274, p = 0.000). In contrast, a higher body mass index (HR = 0.921, p = 0.007) and a longer time to diagnosis (HR = 0.967, p = 0.006), noninvasive ventilation (HR = 0.820, p = 0.000) and percutaneous endoscopic gastrostomy insertion (HR = 0.823, p = 0.000) were associated with better survival. On multivariate analysis, diagnostic delay and slow disease progression were associated with better survival. Conclusions: In our cohort, diagnostic delay and a slow disease progression were significantly associated with better survival in ALS. We also found ethnic variation with Chinese preponderance and more rapid disease progression in patients of Indian descent.

Matched MeSH terms: Prognosis

Fulltext Giant pyogenic granuloma gravidarum of the hand

Khan ES, Ariff MS, Eshagroni A, Haflah NHM, Abdullah S, Sapuan J

International Medical Journal Malaysia, 2014;13(2):55-58.

MyJurnal

We describe a case of a giant pyogenic granuloma affecting the left index finger of a 23-year-old pregnant lady requiring surgical excision. Pyogenic granuloma gravidarum is a benign hyperplastic lesion that commonly presents on oral mucosa, typically the gums, in approximately 5% of pregnant women. Skin lesions over the fingers are an unusual site during pregnancy with only a few cases reported in the literature. The lesion was excised and a diagnosis of lobular capillary haemangioma was made based on histopathological evaluation. We delayed surgery until after parturition since recurrence is likely to be lower due to lower levels of circulating oestrogen and progesterone. The prognosis is usually excellent following resection. However, recurrences have been reported regardless of the treatment method.

Matched MeSH terms: Prognosis

Fulltext Intracranial germinoma – a case report

Subha, S.T., Puaviappan, P., Ramesh, N., Dass, Dipak B

Malaysian Journal of Medicine and Health Sciences, 2013;9(1):81-82.

MyJurnal

Intracranial germinomas belong to the class of germ cell tumors which are relatively rare intracranial tumors. Early recognition of this neoplasm is vital as germinomas are highly radiosensitive and effective/ early radiation therapy can result in relatively favourable overall prognosis. In this article we describe a 19 years old man who presented with pituitary tumor in the suprasellar region for which transsphenoidal decompression and biopsy was done. The histopathological examination confirmed it to be germinoma and he underwent craniospinal radiotherapy.

Matched MeSH terms: Prognosis

Fulltext Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

Sartelli M, Weber DG, Ruppé E, Bassetti M, Wright BJ, Ansaloni L, et al.

World J Emerg Surg, 2016;11:33.

PMID: 27429642 DOI: 10.1186/s13017-016-0089-y

Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.

Matched MeSH terms: Prognosis

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