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A treatment of perforating ulcers in leprosy

Mehta H

Journal of the Malaya Branch of the British Medical Association, 1938;2:88-90.

Matched MeSH terms: Hypesthesia
Fulltext Syringomyelia in Pregnancy - Is Caesarean Section The Best Option For Delivery? - A Case Report

Hakim, B., Roszaman, R., Nor Ziana, A.W., Che Anuar, C.Y., Jefri, A.

International Medical Journal Malaysia, 2009;8(1):39-40.
MyJurnal

Syringomyelia is a rare neurological disease, which is characterized by the formation of a cyst in the spinal cord. The aetiology of the disease still remains controversial. The damage to the spinal cord results in headache, weakness, stiffness and numbness on both lower and upper limbs. Only few a cases of syringomyelia in pregnancy have been reported thus far. As such, there is no standard management of intrapartum care.1 We present a case of symptomatic syringomyelia in pregnancy, its management and literature review. The mode of delivery with risks for vaginal route is discussed.

Matched MeSH terms: Hypesthesia
Submuscular Plate Stabilisation After Lengthening: Standard and Modified Techniques

Munajat I, Sulaiman AR, Mohd EF, Zawawi M

Malays Orthop J, 2020 Mar;14(1):49-54.
PMID: 32296482 DOI: 10.5704/MOJ.2003.008

Introduction: Submuscular plating after lengthening shortened the period of external fixation in distraction osteogenesis of the femur. In the femur, where monolateral or ring fixators had been used for the distraction, plates, could be inserted laterally, anteriorly or medially. Specific technical modification of the plate insertion, however, would be necessary to accommodate the femoral varus angular correction created at the end of the distraction, in the pelvic support osteotomy lengthening.
Material and Methods: We reviewed a series of eight cases with standard and modified techniques of plating after lengthening. The amount of lengthening, the period of distraction, the external fixator index and the associated complications were assessed.
Results: The mean lengthening was 5cm, with a range of 3cm to 9cm. The external fixation index, the period of external fixators in days in relation to the length of distraction in cm, was between 18 days/cm to 58 days/cm. One patient with quadriceps contracture, underwent quadriceplasty to improve knee flexion. Three patients with transient knee stiffness had resolution with aggressive physiotherapy. One patient with transient hypoesthesia recovered spontaneously. None of the patients developed joint subluxation, deep infection, re-fracture or implant failures.
Conclusion: Standard and modified techniques of plating after lengthening were safe and required only a short period of external fixation. The modified technique offered an easier way of plate insertion in a deformed bone.

Matched MeSH terms: Hypesthesia
Fulltext The Clinikal Conundrum Of A Numb Chin

Ghazali, N., Ismail, S.M., Abdul Rahman, Z.A.

Ann Dent, 2001;8(1):-.
MyJurnal

Mental nerve neuropathy is an important presenting complaint that may be encountered by dental surgeons in their daily practise. There are various pathological processes that could bring about this symptom, ranging. from simple dental cause to vague, life threatening diseases. We present three cases of mental paraesthesia of different aetiologies. A literature review on mental nerve neuropathy related to malignancies and infection is discussed. The importance of a thorough chair side history taking, clinical examination and relevant investigations are emphasised in a suggested clinical approach to obtaining the diagnosis of a numb chin.

Matched MeSH terms: Hypesthesia
Fulltext Lumbar Spinal Stenosis: The Reliability, Sensitivity and Specificity of the Nerve Root Sedimentation Sign

Yusof MI, Azizan AF, Abdullah MS

Malays Orthop J, 2018 Jul;12(2):1-6.
PMID: 30112121 MyJurnal DOI: 10.5704/MOJ.1807.001

Introduction: This study is to evaluate the reliability, sensitivity and specificity of nerve root sedimentation sign (NRS) in our populations. The NRS is a radiological sign to diagnose lumbar spinal stenosis (LSS). It is claimed to be reliable with high sensitivity and specificity. Materials and Methods: A total of 82 MRI images from 43 patients in Group A (LSS) and 39 patients in Group B (non LSS) were analysed and compared for the presence of the NRS sign. Two assessors were used to evaluate intra and inter-assessor reliability of this sign based on 56 (33 patients, Group A and 23 patients, Group B). The findings were statistically analysed using SPSS software. Results: There was a significant association between spinal claudication and leg numbness with LSS (p<0.001 and Kappa=0.857, p<0.001). The inter-assessor reliability was also good (Kappa of 0.786, p<0.001). Conclusion: The NRS sign has high sensitivity and specificity for diagnosing LSS. The sign also has good intra and inter-assessor reliability.

Matched MeSH terms: Hypesthesia
Fulltext Diabetic neuropathic cachexia in a young woman

Yusof NA, Idris NS, Zin FM

Korean J Fam Med, 2018 Nov 30.
PMID: 30497111 DOI: 10.4082/kjfm.17.0127

Profound weight loss with painful symmetrical peripheral neuropathy in diabetic patients was first described as diabetic neuropathic cachexia more than 4 decades ago. It is a distinct type of diabetic peripheral neuropathy that occurs in the absence of other microvascular and autonomic complications of diabetes. The mechanism and precipitating cause are unknown. It was reported to have good prognosis with spontaneous recovery within months to 2 years. However, it was frequently missed by clinicians because the profound weight loss is the most outstanding complaint, rather than the pain, numbness, or weakness. This often leads to extensive investigation to exclude more sinister causes of weight loss, particularly malignancy. We report a case of a young woman with well-controlled diabetes who presented with profound unintentional weight loss (26 kg), symmetrical debilitating thigh pain, and clinical signs of peripheral neuropathy. As the disease entity may mimic an inflammatory demyelinating cause of neuropathy, she was treated with a trial of intravenous immunoglobulin, which failed to give any significant benefit. However, she recovered after 6 months without any specific treatment, other than an antidepressant for the neuropathic pain and ongoing rehabilitation.

Matched MeSH terms: Hypesthesia
Fulltext Brown-Séquard Syndrome as a First Presentation of Multiple Sclerosis

Ralot TK, Singh R, Bafna C, Rajesh S, Singh S

Malays J Med Sci, 2017 Aug;24(4):106-110.
PMID: 28951696 DOI: 10.21315/mjms2017.24.4.13

A female patient aged 48 years presented with sub-acute onset of weakness in right upper and lower limb over the past one month and numbness over left side of body below neck level. Multiple sclerosis (MS) presenting as Brown-Séquard syndrome is very rare. We present a case of hemicord myelitis which presented as Brown-Séquard syndrome as a first manifestation, which was later diagnosed as MS during subsequent relapses.

Matched MeSH terms: Hypesthesia
Fulltext Numb chin syndrome: an ominous sign of mandibular metastasis

Razak A, Goh BS, Rajaran JR, Nazimi AJ

BMJ Case Rep, 2018 May 14;2018.
PMID: 29764822 DOI: 10.1136/bcr-2017-223586

A 51-year-old woman a known case of stage 2 breast carcinoma in 2006 and underwent left mastectomy performed in the same year presented with bilateral lower limb pain suggestive of spinal pathology, and left chin numbness, both of 2 weeks' duration. Examination revealed left mandibular hypoesthesia without any other sign or symptoms. Orthopantomogram was unremarkable apart from mild alveolar bone expansion at tooth 36 area, which was extracted 3 months earlier. Subsequently, a full-body positron emission tomography contrast enhanced computer tomography revealed hypermetabolic lesions of her axial (excluding skull) and appendicular skeleton. In the head and neck region, left mandibular foramen and oropharynx bilaterally showed increased metabolism suggestive of tumour metastasis. The diagnosis was numb chin syndrome secondary to mandibular metastasis. Apart from supportive treatment, she was started on palliative chemotherapy and radiotherapy. At the time of discharge, there were no active complaints other than the aforementioned hypoesthesia.

Matched MeSH terms: Hypesthesia/etiology*
Fulltext Impact of carpal tunnel syndrome on the expectant woman's life

Rozali ZI, Noorman FM, De Cruz PK, Feng YK, Razab HW, Sapuan J, et al.

Asia Pac Fam Med, 2012 Jan 30;11(1):1.
PMID: 22283968 DOI: 10.1186/1447-056X-11-1

INTRODUCTION: Carpal Tunnel Syndrome is known to be a common complication during pregnancy especially during the third trimester.

AIM: This article focuses on its impact to the third trimester pregnant mothers with CTS.

METHODS: Third trimester pregnant mothers with no other known risk factors for CTS, were interviewed and examined for a clinical diagnosis of CTS. The severity of CTS was assessed by means of symptoms severity and functionality using the Boston Carpal Tunnel Questionnaire.

RESULTS: Out of 333 third trimester pregnant mothers, 82 (24.6%) were clinically diagnosed with CTS. Malay race was found to have significant correlation with the diagnosis of CTS (p = 0.024) and are two times more likely to get CTS during pregnancy (OR = 2.26) compare to the non-Malays. Bilateral CTS was two times higher (n = 58, 63.4%) than unilateral cases (n = 30, 36.6%), however no significant correlation between the two was found with severity (p = 0.284) or functional (p = 0.906). The commonest complaint was numbness/tingling during day time (n = 63, 76.8%). Majority of the CTS cases were mild (n = 66, 80.5%) and approximately one third (n = 28, 34.1%) had affected hand functions. All symptoms related to pain was found to have significant correlation with severity (p = 0.00, OR = 12.23) and function (p = 0.005, OR = 5.01), whereas numbness and tingling does not (Severity, p = 0.843, function, p = 0.632).

CONCLUSION: This study shows that even though CTS in third trimester pregnancy is prevalent, generally it would be mild. However, function can still be affected especially if patients complain of pain.

Matched MeSH terms: Hypesthesia
Atypical Isolated Infections of the Infratemporal Fossa: A Diagnostic Challenge

Tan SH, Chong AW, Prepageran N

Iran J Otorhinolaryngol, 2015 Sep;27(82):391-4.
PMID: 26568944

INTRODUCTION: Atypical infratemporal fossa infections are rare and potentially fatal.
CASE REPORT: A case of an aspergillosis localized in the infratemporal fossa and another case of tuberculosis of the infratemporal fossa originating from the maxillary sinus, is described. The first patient was immunocompromised and showed symptoms of facial numbness; whereas the other was an immunocompetent man who complained of trigeminal neuralgia type pain. It was difficult to differentiate between infection and tumour despite the utilization of computed tomography scans and magnetic resonance imaging.
CONCLUSION: These cases illustrate the need for a high index of suspicion; in addition to endoscopic confirmation and histopathology to establish precise diagnosis and early intervention.

Matched MeSH terms: Hypesthesia
Fulltext A rare case of neurenteric cyst of spinal cord with thoracic vertebra fusion successfully managed with spinal cyst excision and posterior instrumentation surgery

Tan Jih Huei, Henry Tan Chor Lip, Chan Chee Kong, Ariz Chong B. Abdullah@Chong Chee Yong, Noor Azman Bin A. Rahman

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):348-350.
MyJurnal

The incidence of neurenteric cyst (NC) is rare amongst spine tumors. It is most often asymptomatic but may present
with sensory and motor symptoms. When associated with thoracic vertebra fusion it is not reported before, this complicates the placement of pedicle screw during posterior instrumentation. Herein, we report a case of thoracic spinal
neurenteric cyst in a 40-year-old man that presents with chronic back pain, left lower limb weakness and numbness.
Elective excision of NC over T6-T7 with laminectomy and multilevel posterior instrumentation was successfully
performed with significant improvement of the symptoms. Neurenteric cyst is a rare spinal cord lesion which may
cause permanent neurological sequalae. Complete surgical excision with spine fixation in this case provides good
long-term outcome.

Matched MeSH terms: Hypesthesia
Mouth pain and cheek numbness

Chong W, Musa MSH, Sugumaran V

Emerg Med J, 2020 Jul;37(7):436-443.
PMID: 32616656 DOI: 10.1136/emermed-2019-209395
Matched MeSH terms: Hypesthesia
Heterotopic ossification in psammomatous spinal meningioma: a diagnostic controversy

Wong YP, Tan GC, Mukari SAM, Palaniandy K

Int J Clin Exp Pathol, 2021;14(5):627-632.
PMID: 34093948

Heterotopic ossification (HO), a synonym for osseous metaplasia, is a pathological phenomenon, characterized by abnormal bone formation outside the skeletal system observed commonly in various neoplastic and non-neoplastic diseases. HO occurring in meningioma is exceptionally rare. We reportherein an unusual case of spinal meningioma containing numerous calcified psammoma bodies and extensive HO in a 75-year-old woman, who presented with progressive worsening bilateral lower limb weakness and numbness. The presence of remarkable bone formation within a meningioma is controversial among pathologists; while some regard them as psammomatous meningioma as the primary diagnosis, others prefer osteoblastic meningioma, a form of metaplastic meningioma. There is compelling molecular data to advocate that HO is an active disease process involving metaplastic (osseous) differentiation of meningioma stroma mesenchymal stem-like cells, but not the meningothelial-derived tumor cells. Henceforth, the term "metaplastic meningioma" may not be appropriate in this context. A plausible designation as "psammomatous meningioma with osseous metaplasia" defines this entity more accurately. This paper highlights the need for a unifying nomenclature to reduce diagnostic controversy caused by conflicting terms in the literature. The possible pathogenesis of this intriguing phenomenon is discussed.

Matched MeSH terms: Hypesthesia
In vitro and in vivo Evaluation of New Topical Anaesthetic Cream Formulated with Palm Oil Base

Khodari SNK, Noordin MI, Chan L, Chik Z

Curr Drug Deliv, 2017;14(5):690-695.
PMID: 27480118 DOI: 10.2174/1567201813666160801113302

BACKGROUND: Topical local anaesthetic cream was reported to be useful for pain relief for cutaneous procedures such as minor surgery and venipuncture.
OBJECTIVE: The aim of this study was to evaluate the effectiveness of new formulation of lidocaine topical anaesthetic using palm oil base, HAMIN® and to determine how fast this new formulation produces adequate numbness compared to the currently used EMLA cream, in the University of Malaya Medical Centre (UMMC) set-up.
METHOD: The skin permeation test was conducted by using Franz type diffusion cell and pain assessment was carried out in healthy subject by using Verbal Rating Score (VRS) and Visual Analogue Score (VAS) evaluation.
RESULT: Result of permeation test demonstrated that the cumulative amount of lidocaine released from HAMIN® cream was increased with time and slightly higher than EMLA cream. The clinical study showed that HAMIN® single lidocaine cream can produces numbness through venepuncture procedure and comparable with EMLA cream which is a combination therapy for local anaesthetic (lidocaine and prilocaine).
CONCLUSION: It can be concluded that HAMIN® Lidocaine cream is suitable for cream preparation especially for topical application and it can be regarded as an achievement in palm oil and medical industries.

Matched MeSH terms: Hypesthesia
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: Hypesthesia
Fulltext The prevalence of hand arm vibration syndrome among automobile assembly workers

Shamsul Bahri Mohd Tamrin, Nor MaizuraYusoff, Anita Abd Rahman, Dayana Hazwani, M.S.N., Mansour A. Balkhyour

Malaysian Journal of Public Health Medicine, 2016;16(20):128-136.
MyJurnal

The objectives of this study are to determine the prevalence of hand-arm vibration (HAVS) among the automobile
assembly workers and the associated risks. A cross sectional study was conducted to determine the prevalence of
HAVS and also ascertain the association between HAVS and reduction in VPT among workers using vibration hand held
tool in automobile industry. Aim of this study was to determine the prevalence Hand Arm Vibration Syndrome
(HAVS) among vibrating hand held tool exposed workers. A cross sectional study design using structured
questionnaire and invasive measurement of vibrotactile perception threshold (VPT) at the fingertips was conducted
in one of the automobile company in Klang Valley. All the respondents were hand arm vibration exposed workers. A
total 109 assembly line workers with at least one year job tenure participated in this study. The finding revealed
that 27.5% of workers reported HAVS through questionnaire. This study consisted of 109 respondents. All of them
were male. The mean age was 32.9 years. The mean daily vibration exposure for 8-hours was 1.41m/s2. There was
11% of the tools measured were above the Action Level recommended by European Union Directive 2002. The overall
prevalence of HAVS based on reported symptom through questionnaire was 27.5%. None of the respondent reported
any whiteness at their fingers due to exposure to vibration. However, 36.7% of the respondent reported tingling
sensation and 57.8 % reported the feeling of numbness in their hands. Only 10.1% claim that the pain was
persistence. Since this study was done among exposed workers without control group, the thresholds were measured
by comparing the observed VPT with the VPT of healthy population provided by ISO 13091-2. The result showed that
98.2% of the respondent in this study having positive threshold which indicate the percentage of respondent that
having deterioration in finger tactile perception. The positive threshold from comparison above showed that the
respondent of this study was affected with the vibration exposure. The value proven that the exposure has caused
the deterioration of tactile sensitivity in 98.2% of respondent in this study which showed by having positive threshold
compared to healthy population. The result also showed that there was a significant correlation between daily
vibration exposure A (8) and VPT at both frequency tested which was 31.5Hz (r = 0.417, p = 0.002) and 125Hz (r =
0.480, p = 0.001). Even though the mean daily vibration exposure for 8-hours was low and below the recommended
level, the workers still exposed to the effect of hand arm vibration.

Matched MeSH terms: Hypesthesia
Fulltext Huge brachial plexus schwannoma, masking as a cystic neck mass

Kho JPY, Prepageran N

AME Case Rep, 2018;2:41.
PMID: 30363802 DOI: 10.21037/acr.2018.08.01

Schwannomas are solitary, benign tumors arising from the nerve sheaths. They are frequently reported in the thorax predominantly in the posterior mediastinum, but are rarely seen to arise from the brachial plexus. Schwannomas are well demarcated lesions with a slow insidious growth. Presented is a case of a large brachial plexus schwannoma, masking as a cystic lesion in the lateral neck. The patient presented with concerns of a cystic mass progressively increasing in size over a period of four years, initially symptomless, but later caused numbness and tingling sensation over his right forearm, tip of right thumb and index finger. Following histological confirmation via fine needle aspiration and magnetic resonance imaging, the patient underwent surgical excision where by the tumor was dissected from its attachment to the nerve sheath. The patient recovered well, and by the third day post operatively, his neurological symptoms resolved completely. Upon follow up in clinic 1-week post-surgery, the scar had healed well, and his numbness or tingling sensation remained in abeyance. This case illustrates that a schwannoma may present insidiously as a cystic lesion and its possible origin may arise from the brachial plexus.

Matched MeSH terms: Hypesthesia
Numbness of the ear following inferior alveolar nerve block: the forgotten complication

Ngeow WC, Chai WL

Br Dent J, 2009 Jul 11;207(1):19-21.
PMID: 19590550 DOI: 10.1038/sj.bdj.2009.559

This article presents a distant complication in the auricle following the administration of a standard inferior alveolar nerve block. The patient experienced profound numbness of the auricle on the ipsilateral side of the injection that lasted for about an hour following unintended injection to the auriculotemporal nerve.

Matched MeSH terms: Hypesthesia/etiology*
Satisfaction of orthognathic surgical patients in a Malaysian population

Siow KK, Ong ST, Lian CB, Ngeow WC

J Oral Sci, 2002 Dec;44(3-4):165-71.
PMID: 12613507

Thirty-one patients treated at the Faculty of Dentistry, University of Malaya, were assessed for their satisfaction following orthognathic surgery. The female to male ratio was 22:9 with an age range of 17 to 36. Almost all patients (97%) listed appearance as one of their rationales for surgery. More males (78%) than females (59%) wanted functional improvement, while more females (91%) than males (33%) hoped for improvement in self-confidence. All patients reported esthetic improvement while 68% each reported improvement in mastication and self-confidence. Slightly more than half (52%) chose esthetic improvement as the single most important factor resulting in satisfaction. Almost ninety percent of male patients claimed satisfaction with functional improvement, while 68% of those who found satisfaction in improved self-confidence were females. Eighty-seven percent rated their post-surgical changes as being well accepted by their family. The impact of these findings on the success of the surgery and the need to reinforce verbal communication with printed pamphlets are emphasized.

Matched MeSH terms: Hypesthesia/etiology
Fulltext Anaphylactic shock following the bite of a wild Kayan slow loris (Nycticebus kayan): implications for slow loris conservation

Madani G, Nekaris KA

J Venom Anim Toxins Incl Trop Dis, 2014;20(1):43.
PMID: 25309586 DOI: 10.1186/1678-9199-20-43

BACKGROUND: Asian slow lorises (Nycticebus spp.) are one of few known venomous mammals, yet until now only one published case report has documented the impact of their venomous bite on humans. We describe the reaction of a patient to the bite of a subadult Nycticebus kayan, which occurred in the Mulu District of Sarawak in 2012.

FINDINGS: Within minutes of the bite, the patient experienced paraesthesia in the right side of the jaw, ear and right foot. By 40 minutes, swelling of the face was pronounced. The patient was admitted to Mulu National Park Health Clinic/Klinik Kesihatan Taman Mulu Tarikh, at which time he was experiencing: swollen mouth, chest pain, mild abdominal pain, nausea, numbness of the lips and mouth, shortness of breath, weakness, agitation and the sensation of pressure in the ears due to swelling. The blood pressure was 110/76, the heart ratio was 116 and oxygen saturation was 96%. The patient was treated intramuscularly with adrenaline (0.5 mL), followed by intravenous injection of hydrocortisone (400 mg) and then intravenous fluid therapy of normal saline (500 mg). By 8 h10 the next day, the patient's condition had significantly improved with no nausea, and with blood pressure and pulse rate stable.

CONCLUSIONS: A handful of anecdotes further support the real danger that slow loris bites pose to humans. As the illegal pet trade is a major factor in the decline of these threatened species, we hope that by reporting on the danger of handling these animals it may help to reduce their desirability as a pet.

Matched MeSH terms: Hypesthesia

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