MyMedR

Fulltext CongenCongenital cholesteatoma: Different clinical presentation in two casesital cholesteatoma: Different clinical presentation in two cases

Mohd Khairi Md Daud, Suhaili Abdul Jalil

Malays Fam Physician, 2016;11(23):30-32.

MyJurnal

Congenital cholesteatoma (CC) of the middle ear is a rare entity that may be
undiagnosed for years. The lesion can grow undetected until it produces symptoms such as reduced
hearing or otalgia.

Fulltext Cholesterol granuloma in a post-mastoidectomy for cholesteatoma

Mohd Khairi MD, Ramiza Ramza R

Med J Malaysia, 2012 Apr;67(2):217-8.

PMID: 22822649 MyJurnal

Cholesterol granuloma is a histological term used to describe the foreign body reaction towards cholesterol crystals causing granuloma. We report a case of cholesterol granuloma in a patient who presented with a mass in her ear after 6 years of mastoidectomy. The diagnosis has been confirmed by MRI and postoperative findings. The difference between cholesterol granuloma and the other entities especially cholesteatoma and meningoencephalic herniation must be made in view of its implications and surgical management of each lesion.

Fulltext Congenital mastoid cholesteatoma presenting as a mass obstructing external auditory canal

Khairunnisak M, Mohd Khairi MD

Med J Malaysia, 2014 Dec;69(6):277-8.

PMID: 25934960 MyJurnal

We describe the clinical presentation, investigation and management of an eventually fatal case of hypercalcemic crisis due to primary hyperparathyridism (PHPT). A 60 year-old lady with history of urolithiasis presented with worsening generalized bone pain, spinal scoliosis and a limp. Laboratory data showed hypercalcemia and raised alkaline phosphatase. Left hip x-ray revealed a subcapital femoral neck fracture. Intact parathyroid hormone was elevated, 187.6 pmol/L (1.6 - 6.9) and ultrasound showed an enlarged right parathyroid gland. Despite initial reduction of serum calcium with saline infusion and multiple doses of intravenous pamidronate, her calcium increased to 4.14 mmol/L a week following application of Buck's traction for persistent left hip pain. She succumbed eventually with serum calcium peaking at 6.28 mmol/L despite multiple therapeutic interventions.

Fulltext Hamartomatous polyp of the tonsil: a case report

Wan Faiziah Wan Abdul Rahman, Nur Asyilla Che Jalil, Irfan Mohamad, Mohd Khairi Md Daud

Archives of Orofacial Sciences, 2014;9(2):91-95.

MyJurnal

Hamartomatous polyps of the tonsil are very rare. They have been described using various terms such as a lymphangiomatous polyp, lymphangiectatic fibrous polyp, lipomatous polyp or pedunculated tonsil, thus the actual incidence is difficult to be quantified. We present a case of hamartomatous polyp of the palatine tonsil in a 30-year-old female presented with recurent tonsillitis. Histopathological examination of the resected tonsils showed features of chronic tonsilitis with incidental finding of hamartomatous polyp characterized by a polypoidal tissue covered by stratified squamous epithelium and composed of thin-walled blood vessels, lymphatic channels, fibrofatty tissues, seromucinous glands and striated muscle fibres. An unusual incidental histopathological finding of a rare condition has been discussed along with the review of literature.

Fulltext Effect of oral health education programme on oral health awareness and plaque maturity status among hearing-impaired children

Haliza Tugeman, Normastura Abd Rahman, Azizah Yusoff, Mohd Khairi Md Daud

Archives of Orofacial Sciences, 2018;13(1):22-35.

MyJurnal

Many studies have indicated that hearing-impaired (HI) children have poor oral hygiene mainly
contributed by difficulties in communication. The objectives of the study were to assess the difficulties
experienced by HI children during dental visit and the effectiveness of “Oral Health Care for the HearingImpaired”
(OCHI) programme in improving the oral health knowledge and practice, and reducing the dental
plaque maturity scores among HI children. A community intervention study was conducted and training of trainers
(TOT) was done to train the teachers in delivering oral health education (OHE) and practices by using developed
booklet and video. The difficulties faced by the HI children during dental visit, and the oral health knowledge and
practice (OHKP) were assessed by face-to-face interview with HI children whilst the dental plaque maturity was
assessed using GC Tri Plaque ID Gel™ (TPID) during pre-intervention, post-intervention-1 and postintervention-2.
Data were analysed using SPSS version 22. Among the teachers, there was an increase in the
mean (SD) total knowledge and attitude score during post-TOT compared to pre-TOT, 46.1 (2.44) and 43.7
(4.01); (p

Oral health knowledge, practice and dental plaque maturity status of hearing-impaired children

Haliza Tugeman, Normastura Abd Rahman, Azizah Yusof, Mohd Khairi Md Daud

Sains Malaysiana, 2016;45:761-768.

Hearing impairment is an unseen handicapped that lead to communication barriers which might impede knowledge
transfer. The aim of this study was to compare the oral health knowledge, practice and dental plaque maturity between
hearing-impaired (HI) and normal children. A cross sectional study was conducted among children aged 7-14 years old.
The HI children were recruited from a special school for the deaf while the normal children were from the primary and
secondary schools in Bachok, Kelantan. The oral health knowledge and practice was assessed by face to face interview
whilst the dental plaque maturity status was evaluated using GC Tri Plaque ID Gel™ (TPID). The data was analysed using
IBM SPSS version 22. HI children had poor oral health knowledge and oral health practice compared to normal children
(p<0.05). HI children had significantly more matured plaque compared to normal children with mean (SD) DPMS of 1.8
(0.57) and 1.3 (0.20), respectively (p<0.001). In conclusion, there were poor oral health knowledge, poor oral hygiene
practice and high plaque maturity among HI children.

Fulltext Unilateral foul smelly nasal discharge in an adult

Irfan M, Hasme Zam H, Mohd Khairi M

Malays Fam Physician, 2012;7(1):28-30.

PMID: 25606242 MyJurnal

The incidence of rhinolith is by far very low compared to the nasal foreign bodies, especially in adult. Foreign body (FB) in the nostril will lead to unilateral nasal symptom which can start with nasal obstruction or discomfort. In younger children, they may miss to report the problem to the parents but, later on, the FB will manifest itself with unilateral nasal discharge, which at most of the time fouls smells. We report a case of a healthy adult female who presented with unilateral foul smelly nasal discharge which later was diagnosed as rhinolith, with rubber-tip pencil eraser as the nidus of calcification.

Fulltext Clinical characteristic of vertigo in children

Rosdan S, Basheer L, Mohd Khairi MD

Med J Malaysia, 2015 Aug;70(4):220-3.

PMID: 26358017 MyJurnal

Objective: To review the clinical characteristic of vertigo in children.
Method: A retrospective observational study was done on children who presented to a specialised vertigo clinic over period of six years. The patients’ case notes were retrieved from the medical record unit and reviewed. All patients were seen by an otologist who thoroughly took down history, completed ear, nose, throat and neurological examination.
Result: Seven different causes were identified in 21 patients (86%) while no diagnosis was reached in three patients (12.5%). The most common cause of giddiness was childhood paroxysmal vertigo (33%) followed by benign paroxysmal positional vertigo (16.6%) and sensorineural hearing loss (12.5%). Other causes include chronic suppurative otitis media and anxiety disorder each accounting for 8.3%, one case of cholesteatoma and another case of ear wax each accounting for 4.1%.
Conclusion: It is not uncommon for the children to be affected by vertigo. Management of vertigo in children should include a detailed history, clinical examination, audiological and neurological evaluation. Imaging should be performed in selected patients. The main cause of vertigo in our series is CPV. The outcome of most of the patients is good.

The effect of mild hearing loss on academic performance in primary school children

Khairi Md Daud M, Noor RM, Rahman NA, Sidek DS, Mohamad A

Int J Pediatr Otorhinolaryngol, 2010 Jan;74(1):67-70.

PMID: 19913305 DOI: 10.1016/j.ijporl.2009.10.013

To determine the prevalence of mild hearing loss and its association with academic performance among primary school children.

Fulltext Coblation tonsillectomy versus dissection tonsillectomy: a comparison of intraoperative time, intraoperative blood loss and post-operative pain

Izny Hafiz Z, Rosdan S, Mohd Khairi MD

Med J Malaysia, 2014 Apr;69(2):74-8.

PMID: 25241816 MyJurnal

The objective of this study was to compare the intraoperative time, intraoperative blood loss and post operative pain between coblation tonsillectomy and cold tonsillectomy in the same patient. A prospective single blind control trial was carried out on 34 patients whom underwent tonsillectomy. The patients with known bleeding disorder, history of unilateral peritonsillar abscess and unilateral tonsillar hypertrophy were excluded. Operations were done by a single surgeon using cold dissection tonsillectomy in one side while coblation tonsillectomy in the other. Intraoperative time, intraoperative blood loss and post operative pain during the first 3 days were compared between the two methods. Results showed that the intraoperative time was significantly shorter (p<0.001) and intraoperative blood loss was significantly lesser (p<0.001) in coblation tonsillectomy as compared to cold tonsillectomy. Post operative pain score was significantly less at 6 hours post operation (p<0.001) in coblation tonsillectomy as compared to cold tonsillectomy. However, there were no differences in the post operative pain scores on day 1, 2 and 3. In conclusion, coblation tonsillectomy does have superiority in improving intraoperative efficiency in term of intraoperative time and bleeding compared to cold dissection tonsillectomy. The patient will benefit with minimal post operative pain in the immediate post surgery duration.

Hearing screening of infants in Neonatal Unit, Hospital Universiti Sains Malaysia using transient evoked otoacoustic emissions

Khairi MD, Din S, Shahid H, Normastura AR

J Laryngol Otol, 2005 Sep;119(9):678-83.

PMID: 16156907

The objective of this prospective study was to report on the prevalence of hearing impairment in the neonatal unit population. From 15 February 2000 to 15 March 2000 and from 15 February 2001 to 15 May 2001, 401 neonates were screened using transient evoked otoacoustic emissions (TEOAE) followed by second-stage screening of those infants who failed the initial test. Eight (2 per cent) infants failed one ear and 23 (5.74 per cent) infants failed both ears, adding up to 7.74 per cent planned for second-stage screening. Five out of 22 infants who came for the follow up failed the screening, resulting in a prevalence of hearing impairment of 1 per cent (95 per cent confidence interval [95% CI]: 0.0-2.0). Craniofacial malformations, very low birth weight, ototoxic medication, stigmata/syndromes associated with hearing loss and hyperbilirubinaemia at the level of exchange tranfusion were identified to be independent significant risk factors for hearing impairment, while poor Apgar scores and mechanical ventilation of more than five days were not. In conclusion, hearing screening in high-risk neonates revealed a total of 1 per cent with hearing loss. The changes in the risk profile indicate improved perinatal handling in a neonatal population at risk for hearing disorders.

Fulltext Myxoid Neurofibromas of the External Ear Canal: A Case Report

Maryam YK, Mohd Khairi MD, Asmah Hanim H

Med J Malaysia, 2015 Apr;70(2):102-3.

PMID: 26162387 MyJurnal

Myxoid neurofibroma is benign tumours of perineural cell origin that arise from elements in the peripheral nervous system. We report a case of a 60-year-old female patient presented with history of right ear mass which was slowly growing. Her primary complaint was cosmetic deformity but hearing loss was also present. The mass was excised and histologically revealed a myxoid neurofibroma. To the authors' knowledge, this is the first time that a myxoid neurofibroma arising from external auditory canal is reported. It should be included in the differential diagnosis of a mass originating from this location.
Keywords: Kelantan, Hospital Universiti Sains Malaysia

Anxiety of the mothers with referred baby during Universal Newborn Hearing Screening

Mohd Khairi MD, Rafidah KN, Affizal A, Normastura AR, Suzana M, Normani ZM

Int J Pediatr Otorhinolaryngol, 2011 Apr;75(4):513-7.

PMID: 21292333 DOI: 10.1016/j.ijporl.2011.01.009

To investigate the anxiety among mothers whom their babies have failed test results in the first stage of Universal Neonatal Hearing Screening Program.

Fulltext Dural tear post mastoidectomy repaired with Dura Gen

Wong CY, Khairi MD, Mohamed SA, Irfan M

Med J Malaysia, 2010 Dec;65(4):307-8.

PMID: 21901952

Dural exposure may occur during the course of thinning the tegmen tympani and tegmen mastoideum in mastoid procedure. If large area of dura is exposed or lacerated, cerebrospinal fluid and brain herniation may enter the mastoid cavity. We report a case of a patient with injured dura mater and tegmen mastoideum during mastoidectomy for chronic suppurative otitis media with cholesteatoma managed by using DuraGen. The dura mater and tegmen defect healed totally showing the success of the procedure. A collagen matrix like DuraGen is an option for repairing dural tear in mastoid region.

Fulltext Speech disorders in operated cleft lip and palate children in Northeast Malaysia

Normastura AR, Mohd Khairi MD, Azizah Y, Nizam A, Samsuddin AR, Naing L

Med J Malaysia, 2008 Mar;63(1):21-5.

PMID: 18935726

The aim of this study was to determine the prevalence and association of speech disorders among operated cleft lip and palate children (CLP) in Northeast Malaysia. A comparative cross sectional study was performed on 98 operated CLP and 109 non-cleft subjects that aged between 3- 12-years-old. Data collection was done clinically and also by recording speech samples of each subject from both groups using a portable cassette recorder. Results showed that the prevalence of speech abnormality was 61.2% (95% CI: 51.41-71.04) and the risk of having speech abnormality was 174.5 times (95% CI: 23.04, 1320.67; P value < 0.001) in CLP children compared to non-cleft children. Therefore it was found that children with appropriately repaired CLP in Northeast Malaysia failed to have normal speech.

The association of allergy and chronic suppurative otitis media: A study in a tropical country

Mohd Khairi MD, Shahrjerdi B, Ramiza RR, Normastura R

Med J Malaysia, 2019 Jun;74(3):205-208.

PMID: 31256174

OBJECTIVE: Chronic suppurative otitis media (CSOM) usually begins as a spontaneous perforation of tympanic membrane due to an acute infection of the middle ear. This study was aimed to evaluate the association between allergy and CSOM.

METHODS: A case-control study was carried out among patients with CSOM (cases) and controls were those with no ear pathology. The presence of CSOM was made through a medical history and otoscopic examination. Allergen testing was done by the skin prick test.

RESULTS: In all 124 subjects were recruited in this study with equal number of the cases and controls. The commonest positive reaction in the skin prick test in both groups was to house dust mites. Among CSOM cases, half (50%) of them had an allergy to Blomia tropicalis and 48.4% to Dermatophagoides while in the control group, 27.4% to Dermatophagoides and 25.8% to B. tropicalis. There were significant associations between CSOM and allergy to B. tropicalis (p=0.005), Dermatophagoides (p=0.016) and Felis domesticus (p=0.040). The prevalence of allergy at 95% confidence interval (95%CI) in CSOM and control groups were demonstrated as 59.7% (95%CI: 47.5, 71.9) and 30.6 % (95%CI: 19.1, 42.1) respectively. There was a significant association between allergy and CSOM (p=0.001).

CONCLUSION: Indoor allergens are the most prevalent in our environment and therefore good control may difficult to achieve. The hypersensitivity states of the subject are likely to have a role in the pathogenesis of CSOM especially in the tropical countries where allergy occurs perennially.

Fulltext Auditory neuropathy: three cases among a group with sensorineural hearing loss

Mohd Khairi MD, Normastura AR, Wan Zaharah AW

Singapore Med J, 2009 Sep;50(9):e324-5.

PMID: 19787161

The prevalence of auditory neuropathy is not known, although the majority of cases are felt to lie within the population of neonatal intensive care unit graduates. We report three cases of auditory neuropathy, out of 211 children with sensorineural hearing loss, seen at our audiology clinic from April 1, 1999 to December 31, 2003. Two patients did not have a risk factor for hearing impairment. Screening policies based solely on transient evoked otoacoustic emissions testing will not detect auditory neuropathy effectively, and may falsely reassure parents and professionals unaware of this condition.
Study site: Audiology clinic, Hospital Universiti Sains Malaysia, Kelantan, Malaysia

Screening for gap junction protein beta-2 gene mutations in Malays with autosomal recessive, non-syndromic hearing loss, using denaturing high performance liquid chromatography

Aishah ZS, Khairi MD, Normastura AR, Zafarina Z, Zilfalil BA

J Laryngol Otol, 2008 Dec;122(12):1284-8.

PMID: 18353197 DOI: 10.1017/S0022215108002041

To determine the frequency and type of gap junction protein beta-2 gene mutations in Malay patients with autosomal recessive, non-syndromic hearing loss.

Intradermal Naevi of External Auditory Canal: Unusual location with a unique presentation

Yatiee SL, Mohd Khairi MD, Md Salzihan MS, Ikmal HB

Med J Malaysia, 2018 04;73(2):121-122.

PMID: 29703880 MyJurnal

The incidence of intradermal nevus in the external auditory canal is uncommon. We herein are describing a case of 60-year-old lady who presented with foreign body sensation in the right external ear canal (EAC) with mild discomfort and ear bleed during ear picking. Otoscopic examination revealed hyperpigmented mass on the floor of the outer two third of EAC. Complete excisional biopsy of the mass resulted in histopathology findings of intradermal nevus. Despite the fact that the disease is not alarming, the possibilities of benign melanocytic nevi transformation into malignant lesions such as melanoma need to be ruled out.

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