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Medical Journal of Malaysia

T H Wong, T H Tan, S C Chin, B N Lee
Recently, encapsulated follicular variant of papillary thyroid carcinoma has been reclassified as non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) to emphasize the benign nature of this entity. In our institution, we have assessed 455 patients treated with radioiodine ablation for differentiated thyroid carcinoma and 20 of them were retrospectively found to fulfill the new NIFTP criteria. There was no evidence of metastasis on post radioiodine whole body scans for NIFTP cases and these patients were in remission subsequently...
June 2018: Medical Journal of Malaysia
K G Lim
No abstract provided.
June 2018: Medical Journal of Malaysia
T J Huei, H T C Lip, O Rahmat
Tracheobronchial injuries are uncommon and a high level of suspicion is needed for immediate diagnosis and prompt treatment. In this case series, two rare cases of tracheobronchial injuries is described showing variable clinical presentations with different levels of injury. Our first case was seen in a 20 years old male whom had a direct impact on the neck and presented with upper tracheal injury. On arrival, this patient was in respiratory distress and had bilateral pneumothorax. Bilateral chest tube was inserted with subsequent neck exploration...
June 2018: Medical Journal of Malaysia
R Vijayaraghavan, W Y Thay
Fontan and Baudet described the procedure in 1971 and was very useful to improve the quality of life in many complex cyanotic heart diseases. It has gone through various modifications since then to improve the outcome. The mortality was reported as 2.1% and survival rate of at 5 years, 10 years, 15 years and 20 years were 91%, 80%, 73%and 69% respectively. Though it was a useful palliative procedure to improve the quality of life, it has complications which may affect the morbidity and mortality like Protein loosing enteropathy ,reduced exercise capacity thromboembolism...
June 2018: Medical Journal of Malaysia
A Ishak, A Z Mat Saad, W S Azman, A S Halim
Partial scalp alopecia is a common problem that can lead to severe social and psychological problems. Tissue expansion, although an old concept, provides a surgical alternative to manage areas of alopecia. We describe a case of alopecia secondary to repaired occipital encephalocele that was successfully treated using tissue expansion technique.
June 2018: Medical Journal of Malaysia
Y L Tan, H Y Voon, N Ngeh
We report the peculiar case of a patient who consumed raw rice daily and had iron-deficiency anaemia secondary to menorrhagia with underlying polycystic ovarian syndrome. A 32-year-old lady of Asian descent presented with symptoms of fatigue, lethargy and prolonged, irregular periods for the last two months. There was noticeable increase in body weight, male pattern alopecia and facial acne. In addition, she experienced sudden, unexplained predilection towards consumption of raw rice (up to 300- 400g/day). The patient was treated with oral iron and cyclical progestin...
June 2018: Medical Journal of Malaysia
N M Nasir, F Ariffin, S M Yasin
INTRODUCTION: Medication adherence has been found to be an important determinant in achieving glycaemic control in Type 2 Diabetes (T2DM) patients. In other patient populations, physician-patient interaction satisfaction was found to influence medication adherence. It is then important to identify if this is also a factor amongst T2DM patients on insulin as poor adherence was associated with increased all-cause mortality. METHODS: This was a cross sectional study involving 197 T2DM patients on insulin from two government primary health clinics in Gombak...
June 2018: Medical Journal of Malaysia
R Jeyamalar, W A Wan Azman, H Nawawi, G H Choo, W K Ng, M A Rosli, O Al Fazir, K Sazzli, M Oteh, D K L Quek
Cardiovascular disease (CVD) has been the main cause of mortality and an important cause of morbidity in Malaysia for several years. To reduce global cardiovascular (CV) risk in the population, primary preventive strategies need to be implemented. Hypercholesterolaemia is one of the major risk factors for CVD. This paper is an expert review on the management of hypercholesterolemia focusing on high and very high risk individuals. In low and Intermediate risk individuals, therapeutic lifestyle changes (TLC) and a healthy lifestyle alone may suffice...
June 2018: Medical Journal of Malaysia
N Sivalingam, Y H Teng, X Y Chong, C H Low, S K Manocha, M S Intan Sabreena
INTRODUCTION: The aim of this systematic review is to compare the vaginal erosion rates in different synthetic materials used in suburethral slings in Tension Free Vaginal Tape (TVT-O /TOT) procedures in management of female stress urinary incontinence. METHODS: PRISMA 2009 framework was adopted for study design. Scholarly literature search was done using MEDLINE, EMBASE, the Cochrane Library and Clinical using selected keywords. Five articles fulfilled the inclusion and exclusion criteria...
June 2018: Medical Journal of Malaysia
S Suppiah, S M Ching, A J Nordin, S Vinjamuri
BACKGROUND: Imaging such as Tc99m-HMPAO single photon emission computed tomography (SPECT), and positron emission tomography/ computed tomography (PET/CT) amyloid scans are used to aid the diagnosis of Alzheimer's disease (AD). OBJECTIVE: We aimed to correlate the ability of these modalities to differentiate Probable AD and Possible AD using the clinical diagnosis as a gold standard. We also investigated the correlation of severity of amyloid deposit in the brain with the diagnosis of AD...
June 2018: Medical Journal of Malaysia
W K Chan, K Y Yeoh, C Y Lim, S M Lai, J L Lee, A H R Leow, K L Goh
INTRODUCTION: There have been no published data on the transmission of hepatitis B virus (HBV) infection among children of hepatitis B surface antigen (HBsAg) positive mothers in Malaysia. METHODS: This is a cross-sectional study of all the children of HBsAg-positive mothers who delivered at the University of Malaya Medical Centre between 1993 and 2000. RESULTS: A total of 60 HBsAg-positive mothers and their 154 children participated in the study...
June 2018: Medical Journal of Malaysia
C H Y Kultida, S W Ruedeekorn, H S Keerati
OBJECTIVE: To evaluate the prevalence of coronary artery anatomic variants and anomalies detected by computed tomography angiography (CTA) MATERIALS AND METHODS: A retrospective study was conducted on all patients undergoing coronary CTA using a 64-detector row CT in the Radiology Department, Songklanagarind Hospital, from January 2010 to January 2013. Data were recorded and analyzed. RESULTS: The imaging results of 279 patients were reviewed. One hundred and twenty-two females (43...
June 2018: Medical Journal of Malaysia
V V Vaani, M M Tang, L L Tan, J Asmah
INTRODUCTION: Ultraviolet phototherapies are important treatment modalities for a wide range of dermatological conditions. We aim to describe the utilization of phototherapy in the Department of Dermatology Hospital Kuala Lumpur. METHODS: This is a 5-year retrospective audit on patients who underwent phototherapy between 2011 and 2015. RESULTS: There were 892 patients, M:F=1.08:1, aged from 4- 88 years, with a median age of 38.8 years who underwent phototherapy...
June 2018: Medical Journal of Malaysia
S L Yatiee, M D Mohd Khairi, M S Md Salzihan, H B Ikmal
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...
April 2018: Medical Journal of Malaysia
Z Norazah, D S Joyce Darshinee
Pulmonary veins stenosis in a Down Syndrome infant with normal connection pulmonary vein is rare and precise incidence of this disease is unknown. We report a case of progressive multiple pulmonary vein stenosis in a Down Syndrome infant with congenital heart disease and transient myeloproliferative leukaemia. This case-report aims to improve awareness among physicians and sonographers of this disease and the importance of pulmonary vein assessment in congenital heart disease with unexplained pulmonary hypertension...
April 2018: Medical Journal of Malaysia
A K Noor Khairiah, M N Mohamad Nazrulhisham, G John
Primary osteosarcoma of the spine is indeed rare and only several sporadic cases have been reported. It tends to occur in a slightly older age group than those with appendicular skeleton tumours. We present here an unusual case of aggressive lumbosacral osteosarcoma in a young teenager complicated by extensive dural spread, skip lesions and intravascular extension. Although a histopathological examination is mandatory to establish the diagnosis, this case emphasises the need of imaging to ascertain the full extent of disease spread especially in deciding the type of treatment to be instituted and to evaluate the response to the treatment...
April 2018: Medical Journal of Malaysia
C C Lim, H S Chong, D J Yong, S K Foong, N Prepageran
Schwannoma of cervical sympathetic chain is a rare cause of neck swelling. We report a 73- year-old male presented with anterior neck triangle swelling mimicking a carotid body tumour. Surgical excision was done, and the histopathological examination reported as ancient schwannoma. We would like to discuss the important differential diagnoses and highlight the possibility of an ancient schwannoma of cervical sympathetic chain masquerading as carotid body tumour. Also, to emphasise the importance of imaging for pre-operative planning and counselling...
April 2018: Medical Journal of Malaysia
I Ariffuddin, M S Arman Zaharil, W S Wan Azman, H Ahmad Sukari
High failure rate for recurrent palatal fistulas closure pose a great challenge to plastic surgeons. Tongue and facial artery musculomucosal (FAMM) flaps are the more commonly used flaps for closure of these recurrent fistulas. We report a case of a formerly inset FAMM flap to effectively close a previously repaired oronasal fistula.
April 2018: Medical Journal of Malaysia
A Michael, S Narasimman, N Jasjit Singh
Intra-abdominal heterotopic ossification usually develops after abdominal surgery and can cause complications such as bowel obstruction and even intestinal perforation. Bisphosphonates, NSAIDs and even local radiation is used as prophylaxis or treatment. Surgeons must consider heterotopic ossification and its complications as a differential when managing complex polytrauma patients with suspicious radiographic densities.
April 2018: Medical Journal of Malaysia
B J Mohd Iskandar, T William, J Daisy Vanitha
BACKGROUND: Leptospirosis is a zoonotic disease with symptoms ranging from a mild, febrile illness to a severe form with multiorgan failure. Severe leptospirosis may require medical interventions in the form of dialysis and/or mechanical ventilation and often leads to mortality. An exaggerated host immune response-in particular, a "cytokine storm"-that causes endothelial and organ damage is associated with the disease severity and mortality. METHODS: Microscopic agglutination test (MAT)-positive and MAT-negative human serum samples (n=30) from patients with leptospirosis were obtained from the Public Health Laboratory, Kota Kinabalu, Sabah, Malaysia and control serum samples (n=10) were obtained from healthy student volunteers...
April 2018: Medical Journal of Malaysia
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