MyMedR

Exclusive enteral nutrition is effective and feasible as primary induction and re-induction therapy in Asian children with Crohn's disease

Chan KJ, Song ZL, Chew KS, Ng RT, Mohd Taib SH, Lee WS

J Paediatr Child Health, 2021 Feb;57(2):239-245.

PMID: 32936506 DOI: 10.1111/jpc.15184

AIM: We aimed to ascertain the efficacy and feasibility of exclusive enteral nutrition (EEN) as an induction and re-induction therapy in Asian children with Crohn's disease (CD).

METHODS: All children diagnosed with CD between 1995 and 2019 were reviewed. Response to induction was compared between EEN and standard immunosuppression (IS) using Paediatric Crohn's Disease Activity Index, growth failure, perianal disease and extra-intestinal manifestations. Two study groups were analysed: (i) primary induction and (ii) re-induction for relapses.

RESULTS: Twenty-nine children (mean age (± standard deviation) at diagnosis 9.4 ± 8.5 years old, ileo-colonic 35%, non-stricturing 79%) were studied. At primary induction (group 1; n = 18), no difference was observed in remission rates (9/13 vs. 5/5; P = 0.278), efficacy for improving growth failure (6/8 vs. 0/1; P > 0.999), perianal disease (4/6 vs. 0/2; P > 0.999) and extra-intestinal manifestations (2/2 vs. 0/0; P > 0.999) with EEN or standard IS. Group 2 (n = 38 relapses), no difference was observed in remission rates (16/19 vs. 15/19, P > 0.999), growth failure (0/7 vs. 4/14; P = 0.328), perianal disease (1/10 vs. 7/7; P > 0.999) and extra-intestinal manifestations (0/0 vs. 1/1; P > 0.999) with EEN or standard IS. Both treatment modalities were equally effective as re-induction in relapses in patients previously treated with EEN (P = 0.191).

CONCLUSION: As compared to standard IS, EEN was equally effective in primary induction and re-induction for relapse in Asian children with CD and can be repeatedly used for recurrent relapses.

Matched MeSH terms: Recurrence

A case of acantholytic dermatosis of the vulva with features of pemphigus vegetans

Wong KT, Wong KK

J Cutan Pathol, 1994 Oct;21(5):453-6.

PMID: 7868757

We report an unusual case of vulvar acantholytic dermatosis with features of pemphigus vegetans in a 22-year-old Indian girl who presented with a "warty" lesion in her left labium majus. Following excision of this lesion, she presented with 2 localized recurrent lesions on the left and right labia majora about 2 1/2 years later which were also excised. All 3 biopsies showed histological features typical of pemphigus which included extensive suprabasal acantholysis with bullae formation, prominent villus-like processes at the base of the bullae, focal hyperkeratosis and papillomatosis, and the occasional mixed neutrophil and eosinophilic intraepidermal abscess. IgG and C3 immunofluorescence was positive in the intercellular spaces of the epidermis. These lesions, which probably represent a form of pemphigus vegetans, have not been previously reported as a cause of localized vulvar acantholytic dermatosis.

Matched MeSH terms: Recurrence

Role of radiotherapy in early breast cancer: an overview

Joshi SC, Khan FA, Pant I, Shukla A

Int J Health Sci (Qassim), 2007 Jul;1(2):259-64.

PMID: 21475437

Radiotherapy has an established role in reducing the local relapses in breast cancer patients. The objective of this review was to investigate whether radiotherapy or its omission after breast surgery has measurable consequences on local tumor recurrence and patient survival. The late excess of cardiac deaths has also been published in various reports but important advances in the delivery of radiotherapy have overcome this problem to the extent that, excess cardiac deaths do not appear to be occurring in more recent trials. In this article some recent data, suggesting that radiotherapy following mastectomy and/or breast conserving surgery has a beneficial effect on survival is reviewed. Omission of radiotherapy is associated with a large increase in risk of ipsilateral breast tumor recurrence and with a small increase in the risk of patient's mortality.

Matched MeSH terms: Neoplasm Recurrence, Local

Fulltext Endoscopic Transoral Resection of an Axial Chordoma: A Case Report

Taran S, Yusof AH, Yusof MI

Malays Orthop J, 2015 Nov;9(3):75-77.

PMID: 28611918 MyJurnal DOI: 10.5704/MOJ.1511.015

Upper cervical chordoma (UCC) is rare condition and poses unique challenges to surgeons. Even though transoral approach is commonly employed, a minimally invasive technique has not been established. We report a 44-year old Malay lady who presented with a 1 month history of insidious onset of progressive neck pain without neurological symptoms. She was diagnosed to have an axial (C2) chordoma. Intralesional resection of the tumour was performed transorally using the Destandau endoscopic system (Storz, Germany). Satisfactory intralesional excision of the tumour was achieved. She had a posterior fixation of C1-C4 prior to that. Her symptoms improved postoperatively and there were no complications noted. She underwent adjuvant radiotherapy to minimize local recurrence. Endoscopic excision of UCC via the transoral approach is a safe option as it provides an excellent magnified view and ease of resection while minimizing the operative morbidity.

Matched MeSH terms: Neoplasm Recurrence, Local

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: Recurrence

Fulltext Giant Solitary Forearm Exostosis in A Child

Faisham W.I., Zulmi, W.

Malays Orthop J, 2009;3(1):81-84.

MyJurnal

Forearm deformity secondary to giant solitary ulna exostosis is rare. We describe a rare presentation of symptomatic solitary giant exostosis involving the entire distal ulna resulting in ulnar bowing of the forearm in a five-year-old boy. The tumour was completely resected and the defect was reconstructed with an allograft wrapped with a free autogenous periosteal tubular sleeve to deliver fresh pluripotential cells for better incorporation and integration. The distal ulna physes was preserved. An osteotomy was performed on the radius to correct the deformity. One year after surgery, the deformity remains corrected with normal bone length and excellent hand function. There is no evidence of local recurrence and the allograft has fully incorporated.

Matched MeSH terms: Recurrence

Fulltext Radiation-induced meningioma following radiotherapy for pituitary adenonoma: a case report

Ellyda, M.N., Win Mar@Salmah, J.

International Medical Journal Malaysia, 2013;12(1):63-66.

MyJurnal

It is well known that ionizing radiation has an onco-genetic activity and has been implicated in the causation of brain tumors. However, when a new growth appears adjacent to the site of previous tumor, the diagnosis is more toward recurrence. In addition to that, the possible cause might be overlooked, when it occurs many years after radiation treatment. We report a case of radiation-induced meningioma developed 20 years after the patient received radiotherapy for pituitary adenoma.

Matched MeSH terms: Neoplasm Recurrence, Local

Irritable bowel syndrome and inflammatory bowel disease overlap syndrome: pieces of the puzzle are falling into place

Abdul Rani R, Raja Ali RA, Lee YY

Intest Res, 2016 Oct;14(4):297-304.

PMID: 27799880

Irritable bowel syndrome (IBS), a common gastrointestinal disorder involving the gut-brain axis, and inflammatory bowel disease (IBD), a chronic relapsing inflammatory disorder, are both increasing in incidence and prevalence in Asia. Both have significant overlap in terms of symptoms, pathophysiology, and treatment, suggesting the possibility of IBS and IBD being a single disease entity albeit at opposite ends of the spectrum. We examined the similarities and differences in IBS and IBD, and offer new thoughts and approaches to the disease paradigm.

Matched MeSH terms: Recurrence

Fulltext Thymoma: a case report and review of the literature

Hamidah, A., Poulsaeman, V., Suria, A.A., Zarina, A.L., Zulfiqar, M.A., Jamal, R.

Medicine & Health, 2010;5(1):49-54.

MyJurnal

Thymomas comprise about 1% of all mediastinal tumours and are rare in children. Typically, these tumours are aggressive, with a poor outcome. The current treatment of invasive thymoma is often multidisciplinary. We report a 16-year-old boy with invasive thymoma who was successfully treated with systemic chemotherapy, surgical resection and irradiation. The patient has been in continuous remission for 6 years without radiographic evidence of tumour recurrence.

Matched MeSH terms: Neoplasm Recurrence, Local

Fulltext Oncocytic schneiderian papilloma: a rare sinonasal papilloma removed via endoscopic medial maxillectomy

Faizah, A.R., Mazita, A., Marina, M.B., Jeevanan, J., Isa, M.R.

Medicine & Health, 2010;5(1):55-59.

MyJurnal

There are three types of papilloma which arises from the Schneiderian membrane namely inverted, fungiform and oncocytic. Oncocytic papilloma is the rarest type and occurs predominantly in the older age group. Clinically, its behaviour is similar to inverted papilloma in having both local recurrence and associated malignancy. We report a rare case of oncocytic papilloma arising from the maxillary sinus, extending into the nasal cavity and nasopharynx, in a 78-year-old lady. Despite the longstanding history there was no evidence of associated malignancy in this lesion. An endoscopic medial maxillectomy was successfully utilized for approach and complete tumour excision. In conclusion, oncocytic papilloma should be considered as a differential diagnosis in patients presenting with unilateral polypoid nasal lesions especially in the elderly. In addition, endoscopic medial maxillectomy can provide an adequate approach for complete tumour removal.

Matched MeSH terms: Neoplasm Recurrence, Local

Fulltext Multicompartmental congenital intracranial immature teratoma

Ganesan, Dharmendra, Sheau, Fung Sia, Narayann, Vairavan, Kumar, Gnana, Lum, Lucy, Chan,Lucy, et al.

Neurology Asia, 2013;18(1):117-121.

MyJurnal

Congenital intracranial tumors are rare and account for 0.5 to 1.5% of all childhood tumours. We report a case of a 3 week old baby presenting with multi compartmental congenital intracranial immature teratoma, first of its kind in the literature. The child had gross total excision in two stages with aid of neuronavigation. The short term outcome was good. The four years of follow-up with serial imaging showed no tumour recurrence with a stable hydrocephalus after shunting. However, there is global developmental delay with full time dependence of care giver.

Matched MeSH terms: Neoplasm Recurrence, Local

Fulltext A rare case of recurrent orbital solitary fibrous tumour with intracranial extension

Ainal Adlin N, Umi Kalthum MN, Amizatul Aini S, Reena Rahayu MZ

Journal of Surgical Academia, 2016;6(1):59-61.

MyJurnal

A 47-year-old lady, presented with progressive proptosis of left eye with deterioration of vision. She had a history of left solitary fibrous tumour and had undergone left frontal craniotomy and orbitotomy in 2004. Surveillance Magnetic resonance imaging (MRI) six years later showed tumour recurrence with intracranial extension. However, she did not follow-up and only presented again 3 years, later. Tumour resection and left exenteration was performed. Histology showed ‘patternless’ pattern of neoplastic cells, and CD34 staining was diffusely positive. Diagnosis of recurrent solitary fibrous tumour with intracranial extension was made.

Matched MeSH terms: Neoplasm Recurrence, Local

The pterygium and mitomycin-C therapy

Choon LK, Fong CY

Med J Malaysia, 1976 Sep;31(1):69-72.

PMID: 1023017

Matched MeSH terms: Recurrence

Fulltext The girl with rapunzel syndrome

Norly, S., Noor Saadah, I., Ros'aini, P.

International Medical Journal Malaysia, 2015;14(1):99-101.

MyJurnal

Rapunzel syndrome is a syndrome whereby a gastric trichobezoar (hair ball) extends through the pylorus, in the form of a long tail, to cause gastric outlet obstruction. It was first described by Vaughan et al. in 1968. The syndrome is mostly seen in young females with psychiatric illness. Presentations can be non-specific especially in the early stages. If left untreated it may leads to severe complications, which may include gastric ulceration, intestinal obstruction, perforated viscus and obstructive jaundice. Treatment is essentially surgical and psychi- atric consultation is necessary to prevent relapses. We present the case of a 26-year-old mentally subnormal lady with gastric trichobezoar and provide a review of the literature.

Matched MeSH terms: Recurrence

Fulltext Tissue Diagnosis for Musculoskeletal Tumours

Saw, A.

Malays Orthop J, 2007;1(2):1-2.

MyJurnal

Musculoskeletal tumour is much less common compared to tumours of epithelial origin. Most of these tumours are benign, with only about 1% malignant in nature. A general orthopaedic surgeon may only come across a malignant primary bone or soft tissue tumour a few times in his entire medical career. The current recommendation is for these conditions to be investigated and treated in centres with musculoskeletal oncology service. Careful clinical evaluation with appropriate plain radiography can provide adequate information for definitive diagnosis and treatment for most cases, especially the benign tumours. For some other cases, further investigations will be necessary. Magnetic resonance imaging (MRI) can provide excellent details on anatomical location of a tumour and delineate vital structures that may have been distorted by the lesion. For primary malignant tumours, computerized tomography scanning is still the gold standard for evaluation of pulmonary metastasis, and bone scan can allow early detection of distant metastasis to other bones. Whole body MRI has recently been recommended for tumour staging but the potential benefit for musculoskeletal tumour is not that convincing. PET may be very helpful for follow up detection of tumour recurrence but its role in diagnosis and staging of musculoskeletal tumours is still being evaluated...

Matched MeSH terms: Neoplasm Recurrence, Local

Fulltext Outcome of total thyroidectomy and subtotal thyroidectomy in non toxic multinodular goiter: Hospital Universiti Sains Malaysia experience

Ikhwan, S.M., Irfan, M., Nazli, M.Z.M., Hassan, S., Rahman, M.N.G.

Malaysian Journal of Medicine and Health Sciences, 2013;9(1):3-8.

MyJurnal

Thyroid enlargement is one of the common surgical presentations in the Department of Surgery, Hospital Universiti Sains Malaysia (HUSM). Among them, benign non-toxic multinodular goiter constitutes one third (30%) of patients who underwent thyroidectomy. Common complications of thyroidectomy include recurrent laryngeal nerve (RLN) injury, hypocalcaemia, and recurrence of the thyroid lesion. Objective & Methods: This is a retrospective study of patients diagnosed with multinodular goiter treated in HUSM between January 1996 and December 2005. A total of 111 patients were studied and 52 of them underwent subtotal thyroidectomy while 59 underwent total thyroidectomy. The outcome in terms of RLN injury, hypocalcaemia and mass recurrence were analyzed. Results: Post operative complications were studied in both groups. Permanent recurrent laryngeal nerve injury occurs in 2.4% (1 case) in subtotal thyroidectomy group compared to total thyroidectomy group (3.6%, 2 cases). Five cases from total thyroidectomy group suffered from permanent hypocalcaemia but none in the other group. 70.7% (29 cases) from subtotal thyroidectomy group have functional remnant of thyroid tissue. Recurrence rate post subtotal thyroidectomy after 5 years is only 4.9% (2 cases). Conclusion: The post operative outcome in patients who underwent subtotal thyroidectomy in HUSM from January 1996 to
December 2005 was better than total thyroidectomy with significant functional thyroid remnant.

Matched MeSH terms: Recurrence

Juvenile onset respiratory papillomatosis : a theraputic challenge

Irfan Mohamad, Abdul Halim Shibgatullah, Rosdan Salim

Malaysian Journal of Paediatrics and Child Health, 2007;15(1):37-41.

MyJurnal

Respiratory papillomatosis is a disease of viral origin which is characterized by warty exophytic lesions in the aerodigestive tract. It is the most common benign lesion of larynx and the second most common cause of hoarseness in children. It has the tendency to recur and to spread through out the entire length of the aerodigestive tract. Although a benign disease, it has the potential of morbid consequences in view of airway complications and the risk of malignant transformation. We report a case of juvenile onset of respiratory papillomatosis and its therapeutic challenges.

Matched MeSH terms: Neoplasm Recurrence, Local

Fulltext Clozapine re-challenge with lithium supplementation following clozapine-induced neutropenia

Ahmad Nabil Md Rosli, Subbiah, Rakesh, Maniam, T.

ASEAN Journal of Psychiatry, 2014;15(1):90-92.

MyJurnal

Objectives: This paper aims to report on a case in which re-challenging with clozapine in combination with lithium in a patient who developed neutropenia was carried out. Methods: The patient was treated with clozapine for treatment- resistant schizophrenia. After five weeks he showed much improvement but developed neutropenia. Withdrawal of clozapine brought on a relapse of psychotic symptoms. Subsequently, clozapine was reintroduced along with Lithium. The neutrophil count was monitored closely. Results: The neutrophil and white blood cell count were noted to return to normal upon re-challenging, and the patient’s clinical condition also improved. Conclusion: Simultaneous administration of lithium and clozapine to patients experiencing neutropenia on clozapine is a possible strategy. However, very close monitoring of the white count is needed. ASEAN Journal of Psychiatry, Vol. 15 (1): January - June 2014: 90-92.

Matched MeSH terms: Recurrence

Fulltext Posterior Fossa Intradiploic Epidermoid Cyst: A case report

Ng, Wei Ping, Liew, BS, Gee, TS, Azmin KR

International Medical Journal Malaysia, 2015;14(2):67-70.

MyJurnal

Epidermoid cysts are rare, benign congenital tumours of ectodermal origin which typically present between
the third to fifth decade. These tumours comprise approximately 0.2-1.8% of all intracranial tumours. Though
these pearly tumours are potentially curable, subtotal resection may lead to catastrophic complications such as
recurrence, granulomatous meningitis and carcinomatous degeneration of cyst wall. We herein report the case
of a 36-year-old man who presented with an unusual mixed density posterior fossa epidermoid cyst on imaging
studies. Total removal not only cures both tumour and seizure attack in this case but also preserves patient’s
neurological function.

Matched MeSH terms: Neoplasm Recurrence, Local

Fulltext Improving cancer survivorships: targeting physical activity and inactivity at teachable moments

Loh, S.Y., Chew, S.L.

JUMMEC, 2012;15(1):1-6.

MyJurnal

This article presents a brief overview on the importance of adopting healthy behavior during and after the completion of primary cancer treatment. Increasing evidences are advocating physical activity engagement in cancer survivors due to its convincing beneficial outcomes. Today, outcomes from numerous trials confirmed the need to examine beyond physical activity engagement, into physical inactivity as an independent factor for cancer recurrences. Reducing cancer-risk related behaviors via increase physical activity and reduce inactivity is now receiving much attention in the field of cancer survivorship. Both realms of activity and inactivity are now acknowledged as influential independent factors contributing to better care in the field of cancer survivorship.

Matched MeSH terms: Recurrence

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