Displaying publications 1 - 20 of 65 in total

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  1. Ali S, Ghatwary N, Jha D, Isik-Polat E, Polat G, Yang C, et al.
    Sci Rep, 2024 Jan 23;14(1):2032.
    PMID: 38263232 DOI: 10.1038/s41598-024-52063-x
    Polyps are well-known cancer precursors identified by colonoscopy. However, variability in their size, appearance, and location makes the detection of polyps challenging. Moreover, colonoscopy surveillance and removal of polyps are highly operator-dependent procedures and occur in a highly complex organ topology. There exists a high missed detection rate and incomplete removal of colonic polyps. To assist in clinical procedures and reduce missed rates, automated methods for detecting and segmenting polyps using machine learning have been achieved in past years. However, the major drawback in most of these methods is their ability to generalise to out-of-sample unseen datasets from different centres, populations, modalities, and acquisition systems. To test this hypothesis rigorously, we, together with expert gastroenterologists, curated a multi-centre and multi-population dataset acquired from six different colonoscopy systems and challenged the computational expert teams to develop robust automated detection and segmentation methods in a crowd-sourcing Endoscopic computer vision challenge. This work put forward rigorous generalisability tests and assesses the usability of devised deep learning methods in dynamic and actual clinical colonoscopy procedures. We analyse the results of four top performing teams for the detection task and five top performing teams for the segmentation task. Our analyses demonstrate that the top-ranking teams concentrated mainly on accuracy over the real-time performance required for clinical applicability. We further dissect the devised methods and provide an experiment-based hypothesis that reveals the need for improved generalisability to tackle diversity present in multi-centre datasets and routine clinical procedures.
    Matched MeSH terms: Polyps*
  2. Gendeh BS, Long YT, Misiran K
    Asian J Surg, 2004 Jan;27(1):22-5.
    PMID: 14719510
    Antrochoanal polyps are a rare clinical entity. In this review of patients treated between January 1996 and September 2002, there were 18 cases of antrochoanal polyps. The mean age of patients was 20 years. Nasal obstruction was the most common symptom (17 cases, 94%), followed by rhinorrhoea (44%), epistaxis (33%), postnasal drip (28%), and snoring (22%). Chronic sinus was the most common associated rhinological finding (50%). Various surgical approaches were used: endoscopic polypectomy and middle meatal antrostomy in seven patients (38.9%), endoscopic polypectomy and inferior meatal antrostomy in three patients (16.7%) and Caldwell-Luc surgery in one patient (5.6%). No complications were noted in patients treated with powered instrumentation, including the three patients in whom combined transcanine approaches were used. We concluded that powered endoscopic polypectomy was safe and effective. It allowed a more complete dissection and may diminish the chance of recurrence.
    Matched MeSH terms: Nasal Polyps/complications; Nasal Polyps/diagnosis; Nasal Polyps/surgery*
  3. Khoo JJ, Kumar KS
    Med J Malaysia, 2003 Jun;58(2):282-5.
    PMID: 14569751 MyJurnal
    Rhinosporidiosis is a chronic granulomatous disease of the mucous membrane, predominantly of the nose and nasopharynx. It is uncommon in Malaysia but has been seen in immigrant workers from endemic areas like India and Sri Lanka. A case seen in Johor is reported here to highlight the need of awareness among clinicians at a time where there is increasing numbers of immigrant workers in our country. The causative organism of this disease is Rhinosporidium seeberi, which is found in stagnant waters. Sporangia and endospores of R. seeberi are seen in the granulomatous polypoidal lesions. The patients commonly present with epistaxis and nasal blockage. Complete excision is the treatment of choice for this disease. Recurrences are common despite anti-microbial treatment.
    Matched MeSH terms: Nasal Polyps/diagnosis; Nasal Polyps/etiology*; Nasal Polyps/therapy
  4. Lam SK, Lau GKK
    JGH Open, 2021 Apr;5(4):525-527.
    PMID: 33860106 DOI: 10.1002/jgh3.12496
    Two patients with idiopathic multitudinous fundic gland polyposis, a hitherto undescribed condition, were reported. They presented incidentally with a multitude of fundic gland polyps, 52 and 147, without a family history of polyposis, and these polyps were not attributable to the chronic use of proton pump inhibitors. All polyps were removed by hot-biopsy polypectomy, and each was individually subjected to pathological examination, which showed no evidence of dysplasia. When confronted with gastric polyps of clinically undetermined origin, endoscopists would, to exclude dysplasia, usually resect all if they are few and sample some and survey the others periodically if they are numerous. The condition reported presents a management dilemma: Because the number of the polyps is such that they are manageable by total polypectomy, should this be carried out, despite the labor intensiveness involved, to exclude dysplasia, and are the polyps a variant of syndromic polyposis and therefore carry a malignant potential and inform the need for periodic surveillance and to investigate the patient's kindred? The frequency of this condition and whether it is truly not associated with dysplasia require further studies.
    Matched MeSH terms: Polyps; Adenomatous Polyps
  5. Nor AM, Mohamad AM, Elagili F, Hamdan A
    ANZ J Surg, 2021 12;91(12):2855-2856.
    PMID: 34913562 DOI: 10.1111/ans.17303
    Matched MeSH terms: Polyps*
  6. Shashinder S, Kuljit S, Suhba ST, Arumainathan UD, Gopala KG
    Med J Malaysia, 2007 Mar;62(1):72-3.
    PMID: 17682578
    We describe a child who presented with intermittent respiratory obstruction especially in supine position. Examination revealed a fleshy post nasal mass extending up to the oropharynx. The mass was removed surgically and histopathology revealed an antrochonal polyp. Patient was relieved of his symptoms and has been well ever since.
    Matched MeSH terms: Nasal Polyps/complications*; Nasal Polyps/diagnosis; Nasal Polyps/pathology; Nasal Polyps/surgery
  7. Wan Najmi WD, Noorfizura A, Wan Anna MA
    Med J Malaysia, 2016 02;71(1):35-6.
    PMID: 27130744
    We report a middle age man who presented with intermittent vomiting and loss of weight. Oesophagogastroduodenoscopy showed numerous antral hyperplastic polyps with inaccessible duodenum. Contrast enhanced computed topography demonstrated a classical target sign of intussusception. This finding was later confirmed at laparotomy. This rare presentation and management strategy is discussed.
    Matched MeSH terms: Polyps/complications*; Polyps/microbiology
  8. Munchar J, Rahman HA, Zawawi MM
    Eur J Gastroenterol Hepatol, 2001 Nov;13(11):1385-7.
    PMID: 11692068
    Localized giant pseudopolyposis is an interesting but unusual manifestation of both ulcerative colitis and Crohn's disease. The purpose of this report is to present a case of localized giant pseudopolyposis complicating an ulcerative colitis, and review other cases reported in the literature. The clinical and pathological findings are described. The authors also discuss the possible aspect of proper management in this type of lesion.
    Matched MeSH terms: Colonic Polyps/etiology*; Colonic Polyps/pathology
  9. Irfan M, Shamim AK
    Med J Malaysia, 2009 Mar;64(1):59-60.
    PMID: 19852324 MyJurnal
    Nasal polyp is one of the common causes of nasal obstruction. The diagnosis is usually made on clinical ground and rarely needs histological examination. However, when a candidate is selected for the surgical option of polyp removal, there is tendency to send all specimens for routine histological examination. The objective of this study was to assess the necessity of routinely performed histological examination in all nasal polyp specimens. A retrospective review of all nasal polyp histological reports was done from patients who underwent polypectomy or functional endoscopic sinus surgery in Universiti Sains Malaysia Hospital between January 2000 to July 2006. It consisted of 95 patients. Majority of the reports came back as inflammatory nasal polyp (93.6%) and other varieties of benign nasal mass (5.3%). However, one specimen was noted to be malignant (1.1%). In conclusion all nasal polyp specimens should be sent for histological examination in order to confirm the diagnosis.
    Matched MeSH terms: Nasal Polyps/pathology*
  10. Yang DH, Luvsandagva B, Tran QT, Fauzi A, Piyachaturawat P, Soe T, et al.
    Gut Liver, 2021 05 15;15(3):391-400.
    PMID: 32839364 DOI: 10.5009/gnl20140
    Background/Aims: The clinical practice pattern of polypectomy is not well-investigated in Asian countries. We aimed to survey Asian endoscopists about their preferred polypectomy techniques for given conditions and images of polyps.

    Methods: A survey was performed using questionnaires composed of two parts: a scenario-based questionnaire using scenarios of polyps, which were adopted from the European Society of Gastrointestinal Endoscopy guidelines, and an image-based questionnaire using provided endoscopic images of polyps.

    Results: A total of 154 endoscopists participated in this survey. The most preferred resection techniques for diminutive (≤5 mm), small (6-9 mm), and benign-looking intermediate (10-19 mm) nonpedunculated polyps were cold forceps polypectomy, hot snare polypectomy, and endoscopic mucosal resection (EMR), respectively, in both the scenario- and image-based questionnaires. For benign-looking large (≥20 mm) nonpedunculated polyps, EMR and endoscopic submucosal dissection (ESD) were preferred in the scenario- and image-based surveys, respectively. In case of malignant nonpedunculated polyps, EMR and ESD were preferred for intermediate-sized and large lesions, respectively, according to the scenario-based survey. However, ESD was preferred in both intermediate-sized and large malignant nonpedunculated polyps according to the image-based survey. Trainee endoscopists, endoscopists working in referral centers, and endoscopists in the colorectal cancer-prevalent countries were independently associated with preference of cold snare polypectomy for removing small polyps.

    Conclusions: The polypectomy practice patterns of Asian endoscopists vary, and cold snare polypectomy was not the most preferred resection method for polyps <10 mm in size, in contrast to recent guidelines.

    Matched MeSH terms: Intestinal Polyps/surgery
  11. Kong SS, Taib NA, Mahadeva S
    BMJ Case Rep, 2009;2009.
    PMID: 21686715 DOI: 10.1136/bcr.08.2008.0628
    Intussusception due to small intestinal polyps in Peutz-Jeghers syndrome represents a significant clinical challenge. Neither pure surgical nor endoscopic approaches alone are effective in the long-term management of this problem. We describe a combined approach using both surgery and small bowel endoscopy in the management of this condition, which resulted in both immediate and long-term success. Although not new, we believe this approach remains relevant despite recent technological advancements in this area.
    Matched MeSH terms: Intestinal Polyps
  12. Lim WK, Sdralis T
    Laryngoscope, 2004 May;114(5):903-5.
    PMID: 15126753
    To present an unusual case of a sphenochoanal polyp that regressed and review the etiology of such polyps in comparison to the commoner antrochoanal polyp.
    Matched MeSH terms: Polyps/pathology*; Polyps/radiography*; Polyps/surgery
  13. Tan YJ, Wendy T, Chieng JY
    Med J Malaysia, 2019 02;74(1):20-24.
    PMID: 30846657
    OBJECTIVE: The aim of this study was to evaluate the demography, and to determine the detection rate of polyps, and detection rate of adenoma at a Malaysian tertiary hospital.

    METHODS: This is a retrospective study of all the patients who had undergone colonoscopy at Gastroenterology endoscopy unit, Serdang Hospital from 1st January 2010 to 31st December 2016. Patients who had a history of colorectal cancer, polyp or inflammatory bowel disease were excluded. Data collected which included patients' demography, indication for colonoscopy, colonoscopy finding, and histopathology results. Data was analysed with SPSS version 16.

    RESULTS: Among the 559 patients who had fulfilled the inclusion criteria (68 males, 44 females), 112 patients were found to have at least one polyp giving the polyp detection rate (PDR) of 20% and 168 polypectomies were performed. The PDR among male patients was higher than that of females (22.5% vs 17.1%, p<0.05). The detection rate of polyp was nearly equal in Malays, Chinese, Indians, and Others. The polyps were more common in those of age 40 years old and above (p<0.05), with the mean age of 63.0±1.5 years. The commonest morphology of polyp in our patients was sessile (58%) and majority was medium size (5-9mm). Otherwise, the polyps were commonly found in the distal colon those that in proximal colon (55.3% vs 38.7%, p<0.05). The adenoma detection rate (ADR) was 19.1% (107/559).

    CONCLUSION: The detection rate of colonic polyp from colonoscopy is 20% in our centre.

    Matched MeSH terms: Colonic Polyps/diagnosis*; Colonic Polyps/epidemiology; Colonic Polyps/pathology
  14. Hasme Zam, H., Hazama, M., Suzina, S.A.H., Nik Fariza Husna, N.H., Irfan, M.
    MyJurnal
    Hairy polyps are rare developmental malformations. They are benign lesions presented as a pedunculated mass that may arise from the naso-oropharyngeal region. Larger mass can cause upper respiratory obstruction causing respiratory distress or feeding difficulty, while smaller mass will present as intermittent respiratory distress due to a ball-valve type of obstruction. They are commonly seen in female, with ratio of 6:1 and majority of the cases occur in the infantile period. We are reporting a case of hairy polyp in a female infant that causing intermittent respiratory distress.
    Matched MeSH terms: Polyps
  15. Jabar MF, Prasannan S, Gul YA
    Asian J Surg, 2005 Jan;28(1):58-61.
    PMID: 15691802
    Adult intussusception is a rare entity that may present in the acute and subacute setting principally related to the degree of bowel obstruction. Preoperative diagnosis of this condition may be difficult. The intussusception is usually due to a definable intraluminal lesion, most probably neoplasia, unlike intussusception in children. We present the cases of two adult male patients with intussusception. The first presented with acute small-bowel obstruction secondary to a retrograde ileojejunal intussusception with a pseudopolyp as the lead point. This was possibly due to a retrograde ball-valve effect. The intussuscepting segment was resected. The second patient presented with unexplained chronic diarrhoea and an intussusception occurring within the caecum, as demonstrated at colonoscopy, with a terminal ileal pedunculated fibroid polyp as the lead point. A limited right hemicolectomy was performed. Both patients recovered uneventfully and have remained well. A brief literature review of adult intussusception complements the case reports, with an emphasis on the pathogenesis of inflammatory polyps and recommended surgical management.
    Matched MeSH terms: Intestinal Polyps/complications*
  16. Wong EHC, Chong AW
    Am J Otolaryngol, 2019 12 05;41(2):102367.
    PMID: 31831185 DOI: 10.1016/j.amjoto.2019.102367
    BACKGROUND: Many studies have looked at the effect of functional endoscopic sinus surgeries (FESS) on nasalance, nasal consonant and nasalized vowels. Only two studies investigated the effect of FESS on vocal sound quality and have not found statistically significant changes before and after operations. The aim of this study was to examine the short-term and long-term objective and subjective changes in the vocal quality of patients after FESS, comparing patients with and without nasal polyps.

    METHODS: Sixteen patients were recruited for voice analysis during pre-operative, within two weeks and at least three months post-operatively. Subjective questionnaire was used to assess perception of voice changes.

    RESULTS: There were no statistically significant changes in the acoustic parameters of patients with nasal polyposis. In patients with CRS without polyps, there was a statistically significant increase in fundamental frequency (F0) in nasal sound during early follow up. The changes in soft phonation index (SPI) values between the two groups were statistically significant during early follow-ups. Only patients with nasal polyposis perceived a subjective change in their voice post-operatively.

    CONCLUSIONS: Clinicians should inform all patients, especially voice professionals about the possible effects of endoscopic sinus surgeries on their voice quality.

    Matched MeSH terms: Nasal Polyps*
  17. M Yusoff NNF, Ahmad S, Wan Abdul Rahman WF, Mohamud R, C Boer J, Plebanski M, et al.
    Cytokine, 2024 Jun;178:156557.
    PMID: 38452440 DOI: 10.1016/j.cyto.2024.156557
    Chronic rhinosinusitis with nasal polyps (CRSwNP) is a subtype of chronic rhinosinusitis (CRS) characterized by the presence of nasal polyps (NP) in the paranasal mucosa. Despite the complex etiology, NP is believed to result from chronic inflammation. The long-term aftermath of the type 2 response is responsible for symptoms seen in NP patients, i.e. rhinorrhea, hyposmia, and nasal obstruction. Immune cellular tolerogenic mechanisms, particularly CD4 + Foxp3 + regulatory T cells (Tregs), are crucial to curtail inflammatory responses. Current evidence suggests impaired Treg activity is the main reason underlying the compromise of self-tolerance, contributing to the onset of CRSwNP. There is compelling evidence that tumor necrosis factor 2 (TNFR2) is preferentially expressed by Tregs, and TNFR2 is able to identify the most potent suppressive subset of Tregs. Tumor necrosis factor (TNF)-TNFR2 interaction plays a decisive role in the activation and expansion of Tregs. This review summarizes current understanding of Tregs biology, focusing on the discussion of the recent advances in the study of TNF-TNFR2 axis in the upregulation of Treg function as a negative feedback mechanism in the control of chronic inflammation. The role of dysregulation of Tregs in the immunopathogenesis of CRSwNP will be analyzed. The future perspective on the harnessing Tregs-mediated self-tolerant mechanism in the management of CRSwNP will be introduced.
    Matched MeSH terms: Nasal Polyps*
  18. Abdul Rani R, Hussin FR, Hamzaini AH, Isa MR, Raja Ali RA
    Med J Malaysia, 2016 02;71(1):37-8.
    PMID: 27130745
    Cronkhite-Canada Syndrome (CCS) is a syndrome characterised by a constellation of signs including but not limited to onychodystrophy of the finger and toe nails, skin hyperpigmentation and alopecia. Endoscopic features showed hamartomatous polyps involving all segments of the gastrointestinal tract with the characteristic exception of being oesophageal sparring. These polyps show confirmation by the presence of eosinophils and mast cells at the lamina propria upon histological studies.
    Matched MeSH terms: Polyps
  19. Rajendra S, Kutty K, Karim N
    J Gastroenterol Hepatol, 2003 Jun;18(6):701-4.
    PMID: 12753153
    BACKGROUND: Some two-thirds of colorectal carcinomas arise from adenomatous polyps, and as such, screening by colonoscopy and polyp removal should significantly reduce colorectal cancer. This has not been the case, as evidenced by recent studies, which revealed that endoscopy failed to prevent up to 50% of all subsequent carcinomas. Flat or depressed adenomas, frequently reported from Japan but rarely elsewhere, might explain the 'missed carcinomas.' Detection of flat adenomas has not been previously reported from Malaysia.

    METHODS: In the present prospective study, 426 consecutive patients underwent colonoscopic examination between March 1997 and January 2000, for a variety of bowel symptoms. The examinations were performed by an experienced endoscopist using a standard colonoscope and methylene blue dye spraying technique. Macroscopically, flat adenomas were defined using the criteria proposed by Sawada.

    RESULTS: Twenty-nine adenomas were identified in 12 patients, of which 15 were polypoid and 14 were flat, with no depressed lesions. Eight polypoidal lesions and all the flat adenomas contained mild or moderate areas of epithelial dysplasia. Seven severely dysplastic polyps were identified. One Duke's A polypoidal cancer and two advanced carcinomas were also found. All the severely dysplastic lesions and Duke's A carcinomas were found in polyps greater than 10 mm in mean size. The flat adenomas were all less than 5 mm in size.

    CONCLUSIONS: A significant proportion of colonic adenomas in Malaysian patients appear as small flat lesions, which could easily be missed during endoscopy. Increased recognition and treatment of flat adenomas among colonoscopists is warranted.

    Matched MeSH terms: Colonic Polyps/diagnosis; Colonic Polyps/epidemiology; Colonic Polyps/pathology
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