MyMedR

Fulltext Fatal Pediatric Melioidosis and the Role of Hyperferritinemic Sepsis-Induced Multiple-Organ Dysfunction Syndrome

Mohan A, Paranchothy M, Segaran S, Wong RS, Chor YK, Podin Y, et al.

Am J Trop Med Hyg, 2022 Aug 17;107(2):393-396.

PMID: 35895426 DOI: 10.4269/ajtmh.22-0051

Melioidosis is reported to cause a high fatality rate in children, even in the absence of risk factors for disease. The aim of this study was to identify characteristics of fatal pediatric melioidosis infection. We performed a retrospective analysis of children aged < 15 years with culture-confirmed melioidosis admitted to Bintulu Hospital in Sarawak, Malaysian Borneo, from January 2011 to December 2020. Forty-one children had culture-confirmed melioidosis. Nine (22%) had a fatal outcome; 8 (89%) had no predisposing risk factors. Bacteremia, septic shock, and acute respiratory distress syndrome were present in all fatalities. Demographic characteristics, presenting manifestation, and disseminated infection were not significantly associated with mortality, whereas the presence of splenomegaly, cytopenia, disseminated intravascular coagulation, and hepatobiliary dysfunction, all of which are features of hyperferritinemic sepsis-induced multiple-organ dysfunction syndrome, were associated with mortality. Hyperferritinemic sepsis-induced multiple-organ dysfunction syndrome may be a key component in the pathogenesis of fatal pediatric melioidosis.

Matched MeSH terms: Multiple Organ Failure/etiology

Letter to the editor, "Tooth loss in aggressive periodontitis: a systematic review"

Ramachandra SS

J Dent Res, 2014 Feb;93(2):212.

PMID: 24442399 DOI: 10.1177/0022034513515274

Matched MeSH terms: Tooth Loss/etiology*

Fulltext Factors associated with high alanine aminotransferase (ALT) and cirrhosis in people living with HIV on combination antiretroviral treatment (cART) in the Asia-Pacific

Rupasinghe D, Choi JY, Yunihastuti E, Kiertiburanakul S, Ross J, Ly PS, et al.

J Med Virol, 2022 Nov;94(11):5451-5464.

PMID: 35869413 DOI: 10.1002/jmv.28019

Liver disease is a growing burden among people living with HIV (PLHIV) in resource-limited settings. As an indicator of liver disease, risk factors of high alanine aminotransferase (ALT) and cirrhosis were assessed among PLHIV in the TREAT Asia HIV Observational Database (TAHOD). Patients on combination antiretroviral therapy (cART) with a pre-cART ALT measurement and at least one follow-up ALT measurement were included. Factors associated with high ALT (ALT levels > 5 times its upper limit of normal) were analyzed using repeated measure logistic regression over a 10-year follow-up period. Liver cirrhosis was defined as having an AST to Platelet Ratio Index score > 1.5, fibrosis-4 score > 3.25, or a clinical diagnosis of cirrhosis. Cox regression analysis stratified by site was used to analyze factors associated with cirrhosis among those in follow-up after 2015. Of 5182 patients, 101 patients (1.9%) had high ALT levels with hepatitis C virus (HCV) antibody positive (odds ratio [OR]: 4.98, 95% confidence interval [CI]: 2.82-8.77, p

Matched MeSH terms: Liver Cirrhosis/etiology

Comparing Same-Sitting Bilateral vs Unilateral Retrograde Intrarenal Surgery in the Elderly

Chai CA, Somani B, Castellani D, Fong KY, Sarica K, Emiliani E, et al.

Urology, 2024 Apr;186:117-122.

PMID: 38417468 DOI: 10.1016/j.urology.2024.02.031

OBJECTIVE: To compare same-sitting bilateral vs unilateral retrograde intrarenal surgery (RIRS) in elderly patients, focusing on postoperative complications and stone-free rates (SFR).

METHODS: Data from 2 multicenter databases, FLEXible ureteroscopy Outcomes Registry (FLEXOR) (unilateral RIRS) and same sitting bilateral-retrograde intrarenal surgery (SSB-RIRS) (bilateral RIRS), were analyzed, considering only patients aged 70+ with preoperative computed tomography. Patients were categorized into Group 1 (bilateral RIRS) and Group 2 (unilateral RIRS). Follow-up included imaging assessments and secondary treatments as needed.

RESULTS: Group 1 included 146 patients, while group 2 had 495. Group 1's patients were slightly older and had a higher prevalence of recurrent stone formation. Group 2 often underwent RIRS for incidental stones. Group 1 had larger and more pelvic stones. Laser lithotripsy and total operation times were significantly longer in Group 1. Group 2 had significantly higher overall stone-free rates, although there were no significant differences in ancillary procedures for residual fragments. Group 1 experienced more pelvicalyceal injuries needing stenting, postoperative fever, and post-op hematuria not requiring transfusion.

CONCLUSION: In conclusion, bilateral RIRS can be carefully considered in elderly patients. Preoperative counseling is essential for both primary and repeat RIRS procedures, and further research is needed to optimize instrument and laser strategies for better outcomes in elderly RIRS patients.

Matched MeSH terms: Hematuria/etiology

Fulltext Lessons of the month: A forgotten classic: Delayed diagnosis of mitral stenosis presenting initially as Ortner's syndrome

Shariff RER, Abidin HAZ, Kasim SS

Clin Med (Lond), 2020 Nov;20(6):e267-e268.

PMID: 33199335 DOI: 10.7861/clinmed.2020-0750

We present a rare case of delayed diagnosis of mitral stenosis, initially presenting with hoarseness in her voice due to left recurrent laryngeal nerve (LRLN) compression. A 60-year-old woman presented to the otorhinolaryngology department following complaints of progressive hoarseness in voice over a 6-month period. There was dysphonia but no additional evidence of a cranial nerve IX or X palsy on examination, with subsequent flexible nasopharyngolaryngoscopy demonstrating left vocal cord palsy. She was referred for a cardiology consult following findings of atrial fibrillation on electrocardiography. Transthoracic echocardiography revealed an enlarged left atrium with evidence of severe mitral stenosis. A diagnosis of Ortner's syndrome was made and the patient underwent mitral valve replacement. Common causes of Ortner's syndrome include mitral stenosis with left atrium compression of the LRLN, but it can occur due to other causes including pulmonary hypertension or aortic aneurysm compression, among others. There are few data at present to conclude that regression of left atrial enlargement and pulmonary arterial hypertension with symptoms are associated with Ortner's syndrome. Therefore, it remains pertinent for clinicians to be aware of clinical features linked to mitral stenosis including its more uncommon presentations, such as in our case, as earlier intervention may improve prognosis.

Matched MeSH terms: Hoarseness/etiology

Fulltext Persistent fatigue in patients with COVID-19

Kow CS, Hasan SS

Clin Med (Lond), 2021 Jan;21(1):e117.

PMID: 33479096 DOI: 10.7861/clinmed.Let.21.1.3

Matched MeSH terms: Fatigue/etiology

Heated vegetable oils and cardiovascular disease risk factors

Ng CY, Leong XF, Masbah N, Adam SK, Kamisah Y, Jaarin K

Vascul. Pharmacol., 2014 Apr;61(1):1-9.

PMID: 24632108 DOI: 10.1016/j.vph.2014.02.004

Cardiovascular disease (CVD) is one of the leading major causes of morbidity and mortality worldwide. It may result from the interactions between multiple genetic and environmental factors including sedentary lifestyle and dietary habits. The quality of dietary oils and fats has been widely recognised to be inextricably linked to the pathogenesis of CVD. Vegetable oil is one of the essential dietary components in daily food consumption. However, the benefits of vegetable oil can be deteriorated by repeated heating that leads to lipid oxidation. The practice of using repeatedly heated cooking oil is not uncommon as it will reduce the cost of food preparation. Thermal oxidation yields new functional groups which may be potentially hazardous to cardiovascular health. Prolonged consumption of the repeatedly heated oil has been shown to increase blood pressure and total cholesterol, cause vascular inflammation as well as vascular changes which predispose to atherosclerosis. The harmful effect of heated oils is attributed to products generated from lipid oxidation during heating process. In view of the potential hazard of oxidation products, therefore this review article will provide an insight and awareness to the general public on the consumption of repeatedly heated oils which is detrimental to health.

Matched MeSH terms: Cardiovascular Diseases/etiology*; Hypertension/etiology; Inflammation/etiology; Dyslipidemias/etiology; Atherosclerosis/etiology

Diaphragmatic hernia: an unusual cause of postpartum collapse

Sharifah H, Naidu A, Vimal K

BJOG, 2003 Jul;110(7):701-3.

PMID: 12842063

Matched MeSH terms: Cardiac Output, Low/etiology*; Hernia, Diaphragmatic/etiology*; Puerperal Disorders/etiology*; Respiratory Insufficiency/etiology*; Shock/etiology

The ovaries at abdominal hysterectomy-conservation or removal?

Ong HC

Med J Malaysia, 1975 Sep;30(1):48-51.

PMID: 1207532

Matched MeSH terms: Arteriosclerosis/etiology; Coronary Disease/etiology; Osteoporosis/etiology; Ovarian Diseases/etiology; Ovarian Neoplasms/etiology

Psychiatric sequelae to a civil disturbance

Tan ES, Simons RC

Br J Psychiatry, 1973 Jan;122(566):57-63.

PMID: 4509384

Matched MeSH terms: Feeding and Eating Disorders/etiology; Mental Disorders/etiology*; Depression/etiology; Hallucinations/etiology; Schizophrenia/etiology; Sleep Wake Disorders/etiology

Fulltext Persistent ductus arteriosus in Malaysian patients

Krishnan M, Snelling MR

Br Heart J, 1971 Sep;33(5):699-701.

PMID: 5115012 DOI: 10.1136/hrt.33.5.699

Matched MeSH terms: Bronchitis/etiology; Cough/etiology; Dyspnea/etiology; Edema/etiology; Fever/etiology; Infant Nutrition Disorders/etiology

Post-transfusion hypertension and seizure in congenital hemolytic anemia: a case report and literature review

Ngim CF, Ng CS, Lai NM

J Trop Pediatr, 2014 Jun;60(3):253-6.

PMID: 24473404 DOI: 10.1093/tropej/fmu003

A rare syndrome of hypertension, seizures and intracranial bleed has been reported among patients with congenital hemolytic anemia who underwent multiple blood transfusions. We report this syndrome in a 12-year-old Malay girl with hemoglobin E-beta-thalassemia, who underwent intensive transfusion and subsequently had headache, visual loss, severe hypertension and seizures. A comprehensive literature review revealed 30 patients with this syndrome, of whom 15 had intracranial bleed and 12 among these 15 died. A less-intensive transfusion regimen among patients with chronic hemolytic anemia and prompt detection and management of hypertension may prevent this potentially fatal syndrome.

Matched MeSH terms: Cerebral Hemorrhage/etiology; Headache/etiology; Hypertension/etiology*; Seizures/etiology*

Education and Imaging. Gastrointestinal: massive intraperitoneal haemorrhage in a young woman with hereditary hemorrhagic telangiectasia

Sivarani S, Chan YK, Liam CK, Kumar G, Abdullah BJ, Mahadeva S

J Gastroenterol Hepatol, 2010 Sep;25(9):1587.

PMID: 20796159 DOI: 10.1111/j.1440-1746.2010.06469.x

Matched MeSH terms: Hemoperitoneum/etiology; Hemorrhage/etiology*; Peritoneal Diseases/etiology*; Pregnancy Complications, Cardiovascular/etiology*

Fulltext A young woman with hypogonadism, hypertension and hypokalaemia

Toh VK, Yung CH

Med J Malaysia, 2009 Sep;64(3):242-3.

PMID: 20527279 MyJurnal

We report a case of a 16 years old girl who presented sequentially with primary amenorrhoea, hypertension and hypokalaemia. Eight years later, she was finally diagnosed with 17alpha-hydroxylase deficiency congenital adrenal hyperplasia. Previous antihypertensive medications were stopped. Hydrocortisone alone successfully maintained normotension and normokalaemia.

Matched MeSH terms: Adrenal Hyperplasia, Congenital/etiology*; Hypertension/etiology; Hypogonadism/etiology; Hypokalemia/etiology

Fulltext Kimura's disease: an unusual cause of cervical tumor

Asma A, Maizaton AA

Med J Malaysia, 2005 Aug;60(3):373-6.

PMID: 16379197

Kimura's disease (KD) is an angiolymphoid proliferative disease of soft tissue with peripheral blood eosinophilia and elevated serum immunoglobulin (Ig) E. The treatment options range from conservative observation for the asymptomatic patient to surgical excision, steroid therapy and radiotherapy for symptomatic patients. Surgical excision is the most common diagnostic measure and is the treatment of choice. A case of KD in a 13-year-old Malay girl is presented. Clinically there was painless right jugular digastric mass measuring 3cm by 3cm. Her blood investigation showed pronounced eosinophilia. She underwent excision biopsy uneventfully. The biopsy from the swelling showed reactive follicular hyperplasic with prominent eosinophilia. There was no evidence of malignant change. Postoperatively after 3 years follow up, she was asymptomatic and no signs of tumor recurrence.

Matched MeSH terms: Uterine Cervical Neoplasms/etiology*; Eosinophilia/etiology; Lymphatic Diseases/etiology*; Neoplasms/etiology*

Fulltext Behcet's disease with vascular complications

Normayah K, Mazri YM, Suib I, Zainal AA

Med J Malaysia, 2004 Oct;59(4):547-9.

PMID: 15779593

A young gentleman presented with a history of multiple pseudoaneurysms of the right carotid artery, left radial artery, right femoral artery as well as deep vein thrombosis involving the right femoral vein. A diagnosis of Behcet's disease was made on the basis of his history of recurrent oral and genital ulceration with characteristic eye lesion.

Matched MeSH terms: Carotid Artery Diseases/etiology; Vascular Diseases/etiology*; Aneurysm, False/etiology; Venous Thrombosis/etiology

Fulltext Repair of thoracic oesophageal perforation with latissimus dorsi flap

Yap CM

Med J Malaysia, 1994 Mar;49(1):100-1.

PMID: 8057981

Thoracic oesophageal perforation, a life-threatening condition, is a therapeutic challenge. A 20 year old male developed a lower oesophageal perforation following an abdominal cardiomyotomy for achalasia of the lower oesophagus. The resulting suppurative mediastinitis and left empyema thoracis were treated by decortication. The oesophageal perforation was closed using a transposition pedicle left latissimus dorsi muscle flap.

Matched MeSH terms: Empyema/etiology; Esophageal Perforation/etiology; Intraoperative Complications/etiology; Mediastinitis/etiology

Pigbel in Papua New Guinea: an ancient disease rediscovered

Murrell TG

Int J Epidemiol, 1983 Jun;12(2):211-4.

PMID: 6307898

A hypothesis suggested in this paper is that pigbel, or enteritis necroticans was a common disease in mediaeval Europe when human habitats, food hygiene, protein deficiency and periodic meat feasting formed the basics of village life as they do in many Third World cultures today. Based on the Papua New Guinea experience with pigbel, it is suggested that health authorities should look closely at the epidemiology of the acute surgical abdomen in such communities. Enteritis necroticans may be the important predisposing lesion to mid-gut volvulus, jejunal and ileal ileus and other forms of small bowel strangulation in communities where protein deprivation, poor food hygiene, epochal meat feasting and staple diets containing trypsin inhibitors co-exist. Such human habitats occur in Central South America, Western Pacific, Asian and South-East Asian cultures. Isolated outbreaks of necrotising enteritis have been reported from Uganda, Malaysia and Indonesia but as yet no systematic epidemiological studies of the prevalence of small bowel strangulations have been described in the surgical literature of Third World countries. Now that enteritis necroticans is preventable by vaccination such studies should be undertaken.

Matched MeSH terms: Abdomen, Acute/etiology*; Clostridium Infections/etiology*; Enteritis/etiology*; Intestinal Obstruction/etiology*

The tampered implant. Intra-medullary nailing of the femur for fracture of the shaft-unusual difficulty in extraction: case report

Subramanian N

Med J Malaysia, 1973 Dec;28(2):123-4.

PMID: 4276229

Matched MeSH terms: Bone Diseases/etiology; Fistula/etiology; Osteomyelitis/etiology; Skin Diseases/etiology

Right hydronephrosis and vesicocolic fistula complicating sigmoid colonic diverticulitis: report of a case

Ng KK, Tan KM, Lim KT

Dis Colon Rectum, 1975 Oct;18(7):623-5.

PMID: 1181168

Matched MeSH terms: Urinary Bladder Fistula/etiology*; Colonic Diseases/etiology*; Hydronephrosis/etiology*; Intestinal Fistula/etiology*

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