MyMedR

Total paralysis regime in severe tetanus

Alhady SMA, Bowler DP, Reid HA, Scott LT

Br Med J, 1960;1:540-545.

Tetanus may be mild, moderate, severe, or inevitably fatal. Our clinical experience suggests it may be classified as severe (or, maybe, inevitably fatal) when a tetanic spasm stops respiration. Ten patients with severe tetanus were treated by the total paralysis regime (T.P.R.), consisting of tracheostomy, curarization, and intermittent positiveor positive/negative-pressure respiration. Two of the patients were saved by T.P.R. and therefore only limited effectiveness can be claimed for the regime. In inevitably fatal cases survival can be prolonged by T.P.R. so that further effects of tetanus toxin emerge. Of these, the most important appears to be direct damage to the myocardium.

Matched MeSH terms: Spasm

It's not just a heartburn and reflux disease: a case report of distal oesophageal spasm and review of literature

Nawawi KNM, Wong Z, Ngiu CS, Raja Ali RA

Med J Malaysia, 2019 12;74(6):540-542.

PMID: 31929483

Distal oesophageal spasm is a rare condition that affects the motility of the oesophagus. It can be diagnosed by highresolution oesophageal manometry and the diagnosis is supported by other modalities such as barium swallow and esophagogastroduodenoscopy examinations. Treatment options include pharmacological therapy, endoscopy and surgical interventions. We described a case of distal oesophageal spasm in an elderly patient who presented with chronic dyspepsia.

Matched MeSH terms: Esophageal Spasm, Diffuse/complications; Esophageal Spasm, Diffuse/diagnosis*; Esophageal Spasm, Diffuse/physiopathology

Fulltext Re-Emergence of Tetanus in a District Referral Hospital

Ariff HH, Verghese A, Brian CMK

International Medical Journal Malaysia, 2017;16(1):127-130.

MyJurnal

Tetanus is an acute, potentially fatal disease caused by Clostridium tetani. It is characterized by generalized, painful spasms and rigidity of skeletal muscles. We present two fatal cases and discuss the potential causes that lead to mortality in cases of tetanus infection

Matched MeSH terms: Spasm

Fulltext Severe and fatal postoperative bronchospasm in a child with a pulmonary artery sling

Norzila MZ, Azizi BH, Mazeni A, Ahmad S, Devadass P, Lokman S

Med J Malaysia, 1994 Jun;49(2):182-4.

PMID: 8090102

We report a case of left pulmonary artery sling in a child who also had duodenal atresia. He was admitted for respiratory failure requiring prolonged respiratory support due to a bronchiolitis-like illness at two months of age. Diagnostic procedures confirmed the presence of left pulmonary artery sling. He had a corrective procedure which relieved the compression. However postoperatively he had intermittent episodes of severe bronchospasm in addition to a persistent airway obstruction. Finally one such episode of severe bronchospasm did not respond to medical and resuscitative therapy and the baby succumbed. To our knowledge no case of left pulmonary artery sling has been described previously in a Malaysian child. This case also highlights the postoperative airway problems that may be encountered.

Matched MeSH terms: Bronchial Spasm/etiology*

Severe bronchospasm during epidural anaesthesia

Wang CY, Ong GS

Anaesthesia, 1993 Jun;48(6):514-5.

PMID: 8322993

A case of severe bronchospasm occurring during epidural anaesthesia in a patient undergoing Caesarean section is described. The aetiology of the bronchospasm may have been related to sympathetic nervous blockade allowing unopposed parasympathetically mediated bronchoconstriction.

Matched MeSH terms: Bronchial Spasm/etiology*

Fulltext Clinical assessment and grading of back pain in horses

Mayaki AM, Abdul Razak IS, Adzahan NM, Mazlan M, Rasedee A

J Vet Sci, 2020 Nov;21(6):e82.

PMID: 33263229 DOI: 10.4142/jvs.2020.21.e82

BACKGROUND: The clinical presentation of horses with back pain (BP) vary considerably with most horse's willingness to take part in athletic or riding purpose becoming impossible. However, there are some clinical features that are directly responsible for the loss or failure of performance.

OBJECTIVES: To investigate the clinical features of the thoracolumbar region associated with BP in horses and to use some of the clinical features to classify equine BP.

METHODS: Twenty-four horses comprised of 14 with BP and 10 apparently healthy horses were assessed for clinical abnormality that best differentiate BP from normal horses. The horses were then graded (0-5) using the degree of pain response, muscular hypertonicity, thoracolumbar joint stiffness and overall physical dysfunction of the horse.

RESULTS: The common clinical features that significantly differentiate horses with BP from non-BP were longissimus dorsi spasm at palpation (78.6%), paravertebral muscle stiffness (64.3%), resist lateral bending (64.3%), and poor hindlimb impulsion (85.7%). There were significantly (p < 0.05) higher scores for pain response to palpation, muscular hypertonicity, thoracolumbar joint stiffness and physical dysfunction among horses with BP in relation to non-BP. A significant relationship exists between all the graded abnormalities. Based on the cumulative score, horses with BP were categorized into mild, mild-moderate, moderate and severe cases.

CONCLUSIONS: BP in horse can be differentiated by severity of pain response to back palpation, back muscle hypertonicity, thoracolumbar joint stiffness, physical dysfunctions and their cumulative grading score is useful in the assessment and categorization of BP in horses.

Matched MeSH terms: Spasm

Fulltext Smoker Desaturation during General Anaesthesia: A Case Report

Hadi, M.A., Azrina, M.R., Zamzila, A., Ariff, O.

International Medical Journal Malaysia, 2009;8(1):57-59.

MyJurnal

We report a case of sudden hypoxaemia after intubation in a patient who had smoked a few hours prior to a surgical procedure. The cause of his desaturation was not related to bronchial secretions, bronchospasm or obstruction of the upper airways but most likely due to reduced oxygen saturation in the body prior to surgery. We managed to secure the airway and prevent prolonged desaturation by instituting remedial measures. Our conclusion is that cessation of smoking is very important and need to be emphasized in all patients having surgery under general anaesthesia. This applies to emergency cases as well.

Matched MeSH terms: Bronchial Spasm

Fulltext Successful Modified Desensitization Therapy with Analog Insulin in an Individual with Severe Allergy to Multiple Insulin Preparations: A Case Report

Seman WJW, Nasruddin AB, Noor NM

J ASEAN Fed Endocr Soc, 2018;33(1):53-56.

PMID: 33442111 DOI: 10.15605/jafes.033.01.09

We present a case of a 27-year-old female with T2 DM who developed allergic reactions after commencement of insulin therapy. Trial with different types of insulin resulted in a series of allergic reactions ranging from urticarial rash to development of angioedema, bronchospasm and anaphylactic shock. She was successfully treated with a modified insulin desensitization protocol using rapid-acting insulin.

Matched MeSH terms: Bronchial Spasm

Use of capnography delaying the diagnosis of tracheal intubation

Chan YK, Zuraidah S, Tan PS

Anaesthesia, 1998 Dec;53(12):1207-8.

PMID: 10193227

There was a delay in making the correct diagnosis of tracheal intubation in a parturient who developed severe bronchospasm after intubation because we relied on the capnogram.

Matched MeSH terms: Bronchial Spasm/diagnosis*

Oculogyric spasm in Asian psychiatric in-patients on maintenance medication

Tan CH, Chiang PC, Ng LL, Chee KT

Br J Psychiatry, 1994 Sep;165(3):381-3.

PMID: 7994510

BACKGROUND: The objective was to investigate the occurrence and characteristics of oculogyric spasm (OGS) in an Asian country.

METHOD: All 2035 Asian (88% Chinese, 7% Malays and 5% Indonesians) psychiatric in-patients in the state psychiatric hospital in Singapore were surveyed for occurrence of oculogyric spasm (OGS) over a two-month period.

RESULTS: Thirty-four patients (1.7%) developed OGS (53% male and 47% female). All the 34 patients had been on maintenance antipsychotic drugs for more than five months. Eighteen patients had recurrent attacks. The mean chlorpromazine equivalent daily dose for those patients with recurrent OGS was 511 mg. This was significantly higher (P < 0.05) than the 277 mg daily dose received by those without recurrent OGS. Most (68%) of the attacks occurred between 1400-2000 h suggesting that OGS may have a diurnal variation.

CONCLUSIONS: OGS presenting as tardive dystonia may be due to a relative increase in cholinergic activity.

Matched MeSH terms: Spasm/chemically induced*; Spasm/diagnosis; Spasm/ethnology

Fulltext Trapped cystofix: Laparoscopic modality to untie

Muhamad A, Johan S, Khairuddin A, Hayati F, Payus AO, Zainal Abidin ZA

Urol Case Rep, 2021 Jan;34:101448.

PMID: 33088720 DOI: 10.1016/j.eucr.2020.101448

Suprapubic catheterization (SPC) is a temporary measure to relieve acute urinary retention (AUR). Despite being effective, it can lead to complications such as colon perforation, haematuria, and bladder wall spasm. We present a 52-year-old lady with cystofix for underlying urethral stricture presented with AUR. A new SPC was inserted to drain the urine. However, the SPC had looped and entangled with her cystofix, and laparoscopic removal of cystofix and insertion of a new SPC was done. In conclusion, trapped cystofix to the SPC tube is a potential complication during SPC insertion that can be avoided with appropriate care.

Matched MeSH terms: Spasm

Fulltext Coronary artery spasm: A quandary

Ngow, H.A., Wan Khairina, W.M.N.

International Medical Journal Malaysia, 2011;10(1):53-55.

MyJurnal

Coronary artery spasm can result in acute coronary syndrome. This vasospastic syndrome can cause profound morbidity and mortality as a significant proportion of patients continue to have angina despite optimal medical therapy. We illustrate the dilemma in managing a young woman who presented with non ST-segment myocardial infarction as a result of it. She did not have the conventional risks for coronary artery disease except the family history of myocardial infarction. Vasospasm was demonstrated at the mid right coronary artery which resolved with intracoronary nitroglycerine during angiogram. Most women with no significant heart disease following demonstration of normal or “near normal” coronary arteries after angiography are offered no treatment beyond reassurance each year. New data suggest that this approach may no longer be appropriate and the prognosis in such patient is not as benign as previously thought. We discuss the management dilemma of such patient with associated mild atherosclerotic plaque.

Matched MeSH terms: Coronary Vasospasm; Spasm

Fulltext An adult with thumb sign In the lateral neck radiograph

Irfan Mohamad, Mohd Syafwan Mohd Soffian, Amran Mohamad

Malaysian Journal of Medicine and Health Sciences, 2015;11(1):85-88.

MyJurnal

Acute epiglottitis though relatively common in pediatric patients as compared to adults, present with almost similar clinical presentations. They include voice change, difficulty or painful swallowing and sometimes with upper airway obstruction. Physical finding of swollen epiglottis is difficult to be obtained owing to the danger of introducing laryngeal mirror into the oropharynx as to avoid contact spasm. The diagnostic thumb sign appearance on lateral neck radiograph is considered pathognomonic of epiglottitis. We report a case of an adult with clinical features and radiological finding of an acute epiglottitis, which did not resolve with antibiotic treatment. Subsequent imaging confirmed the presence of an abscess in the epiglottic mucosa.

Matched MeSH terms: Spasm

Fulltext Jellyfish Envenomation Resulting In Vascular Insufficiency And Neurogenic Injury of Upper Limb

Choong C, Chan HZ, Faruk NA, Bea KC, Zulkiflee O

Malays Orthop J, 2015 Nov;9(3):49-51.

PMID: 28611910 MyJurnal DOI: 10.5704/MOJ.1511.007

Following a week after a jellyfish sting, a young man presented with regional cyanosis and threat of distal gangrene secondary to vascular spasm in the forearm. The patient also suffered from transient paresis and numbness of the affected upper limb. Contrasted imaging revealed unopacified vessels in the distal forearm and worsening swelling warranted emergency surgical fasciotomy for impending compartment syndrome. This case highlights the occurrence of jellyfish envenomation and the need for early treatment.

Matched MeSH terms: Spasm

Fulltext Effect of Zingiber officinale on spasm

Nadia, Hisamuddin, Nadhirah, Kamarudin, Mohd Roslan, Sulaiman, Wan Mastura, Shaik Mossadeq

The Pertanika Journal of Scholarly Research Reviews, 2019;5(1):27-36.

MyJurnal

Zingiberaceae is one of the largest plant families consisting of rhizomes that are commonly used as spice in soups and curries as well as alternative medications in folklore medicine. Zingiber officinale or commonly known as ginger is extensively employed in Asian, Ayurvedic, Chinese, and Arabian folklore medicine for the treatment of pain, inflammation and various spasm-associated gastric ailments. The past few decades saw rapid advancements in the extraction process of ginger bioactive constituents and validation of their corresponding pharmacodynamic and pharmacotherapeutic activities, and biological properties in vivo and in vitro. Results reported from several biological studies on ginger showed that extracts and compounds from this tuberous rhizome exhibit antiemetic, anticancer, antipyretic, antispasmogenic and antimicrobial activities. This article reviews the effect of Zingiber officinale and its bioactive constituents on isolated organ preparations from several species of animals in view of its potential use as an alternative treatment for muscle spasms and common gastric ailments.

Matched MeSH terms: Spasm

Fulltext Case report: Unusual cause of difficulty in intubation and ventilation with asthmatic-like presentation of Endobronchial Tuberculosis

Seevaunnamtum SP, Mohd Ariff Ghazali NA, Nazaruddin WM, Besari AM, Fariza NHN, Omar SC, et al.

Respir Med Case Rep, 2017;22:292-294.

PMID: 29159029 DOI: 10.1016/j.rmcr.2017.10.011

Endobronchial Tuberculosis is hazardous in causing circumferential narrowing of tracheobronchial tree despite the eradication of tubercle bacilli in the initial insult from Pulmonary Tuberculosis. They may present as treatment resistant bronchial asthma and pose challenge to airway management in the acute setting. We present a 25 year-old lady who was newly diagnosed bronchial asthma with a past history of Pulmonary Tuberculosis that had completed treatment. She presented with sudden onset of difficulty breathing associated with noisy breathing for 3 days and hoarseness of voice for 6 months. Due to resistant bronchospasm, attempts were made to secure the airway which led to unanticipated difficult intubation and ventilation. Subsequent investigations confirmed the diagnosis of Endobronchial Tuberculosis and patient was managed successfully with anti TB medication, corticosteroids and multiple sessions of tracheal dilatation for tracheal stenosis. This case highlights the unusual cause of difficulty in intubation and ventilation due to Endobronchial Tuberculosis, which required medical and surgical intervention to improve the condition.

Matched MeSH terms: Bronchial Spasm

Fulltext Supraventricular Tachycardia: An Unusual Side Effects of Cefuroxime

Yeap, Boon Tat, Yeoh, Boon Seng, Rajesh Kumar Muniandy

Borneo Journal of Medical Sciences, 2019;13(2):35-38.

MyJurnal

Anaphylactic reaction towards antibiotics is common during anaesthesia. It may present as bronchospasm, hypotension, desaturation, or urticarial. However it is uncommon for anaphylaxis reaction to present only as supraventricular tachycardia (SVT). This is a rare interesting case report on a 23-year-old healthy man whose anaesthetic categorization is American Society of Anaesthesiologist (ASA) 1, developed supraventricular tachycardia (SVT) towards intravenous cefuroxime, peri operatively. His condition resolved with carotid sinus massage. No pharmacological interventions were used. His skin prick intradermal tests showed allergies towards cefuroxime, cefazoline and cefoperazone. The patient subsequently underwent.

Matched MeSH terms: Bronchial Spasm

Neuropharmacological potentials of β-carboline alkaloids for neuropsychiatric disorders

Ayipo YO, Mordi MN, Mustapha M, Damodaran T

Eur J Pharmacol, 2021 Feb 15;893:173837.

PMID: 33359647 DOI: 10.1016/j.ejphar.2020.173837

Neuropsychiatric disorders are diseases of the central nervous system (CNS) which are characterised by complex pathomechanisms that including homeostatic failure, malfunction, atrophy, pathology remodelling and reactivity anomaly of the neuronal system where treatment options remain challenging. β-Carboline (βC) alkaloids are scaffolds of structurally diverse tricyclic pyrido[3,4-b]indole alkaloid with vast occurrence in nature. Their unique structural features which favour interactions with enzymes and protein receptor targets account for their potent neuropharmacological properties. However, our current understanding of their biological mechanisms for these beneficial effects, especially for neuropsychiatric disorders is sparse. Therefore, we present a comprehensive review of the scientific progress in the last two decades on the prospective pharmacology and physiology of the βC alkaloids in the treatment of some neuropsychiatric conditions such as depression, anxiety, Alzheimer's disease, Parkinson's disease, brain tumour, essential tremor, epilepsy and seizure, licking behaviour, dystonia, agnosia, spasm, positive ingestive response as demonstrated in non-clinical models. The current evidence supports that βC alkaloids offer potential therapeutic agents against most of these disorders and amenable for further drug design.

Matched MeSH terms: Spasm

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