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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
W K H Mok, B K Poh, L H Wee, D G Devanthini, A T Ruzita
INTRODUCTION: Obesity and physical inactivity among school children are among the most challenging health problems in Malaysia. The present study aimed to evaluate the sustained impact of Juara Sihat programme on physical activity level and anthropometric status at 18-month post-intervention. METHOD: Participants of Juara Sihat (n=55) were followed-up at 18 months after completion of the intervention. Juara Sihat intervention was implemented over 12 weeks and focused on four key components: (i) five one-hour nutrition education classes, (ii) four one-hour physical activity education sessions, (iii) family involvement, and (iv) empowerment of Parents and Teachers Association...
April 2018: Medical Journal of Malaysia
Y Y Chin, H Sakinah, A Aryati, B M Hassan
INTRODUCTION: In most Asian countries, stroke is one of the major causes of mortality. A stroke event is life-changing for stroke survivors, which results in either mortality or disability. Therefore, this study comprehensively focuses on prevalence, risk factors, and secondary prevention for stroke recurrence identified in South, East, and Southeast Asian countries. METHODS: This scoping review uses the methodological framework of Arksey and O'Malley. A comprehensive search of academic journals (English) on this topic published from 2007 to 2017 was conducted...
April 2018: Medical Journal of Malaysia
P Pang, Y S Ng, J Sidhu, M Kok
AIM: To record the incidence and prevalence of inflammatory bowel disease (IBD), its social demographics, clinical characteristics and treatment, in the state of Johor, Malaysia. METHODS: Hospital Sultanah Aminah, Johor Bahru, is the only public hospital in Johor with a Gastroenterology service. Data on all existing and new IBD patients managed by the Gastroenterology Unit in 2016 were collected. Incidence and prevalence of IBD in 2016 were then calculated based on the estimated population of Johor and Johor Bahru...
April 2018: Medical Journal of Malaysia
J W Kuan, S Melaine Michael
OBJECTIVES: There are very few published chronic myeloid leukaemia (CML) epidemiology studies in South-East Asia and no representative from Malaysia. METHODS: This is a cross-sectional study of adult CML patients (citizen) in a single but representative centre in southern Sarawak. RESULTS: Total 79 patients (Malay 39%, Chinese 30.4%, Iban 17.7%, Bidayuh 12.7%) were identified from the databases. Median age at diagnosis was younger, 40, compared to developed countries due to population structure...
April 2018: Medical Journal of Malaysia
C H Loo, W C Tan, Y H Khor, L C Chan
INTRODUCTION: Severe cutaneous adverse drug reactions (SCARs) are not uncommon and potentially lifethreatening. Our objective is to study the patient characteristics, the pattern of implicated drugs and treatment outcome among patients with SCARs. METHODS: A 10-year retrospective analysis of SCARs cases in Penang General Hospital was carried out from January 2006 to December 2015. Data collection is based on the Malaysian Adverse Drug Reactions Advisory Committee registry and dermatology clinic records...
April 2018: Medical Journal of Malaysia
M Z Nurulain, S Ahmad, H Asma, M Abdul
OBJECTIVE: Cataract is the leading cause of blindness in Malaysia. There is an alarming backlog of cataract extraction surgery as the majority believes they did not require surgery. This study aimed to explore the barriers at the primary care level to cataract surgery from the perspective of patients with severe cataract blindness. METHODS: Eleven participants were involved in this qualitative research which utilised the interpretative phenomenological analysis approach more renowned in health psychology research...
April 2018: Medical Journal of Malaysia
A M Normaliza, M Y Sa'ari, L S Leonard, M G Colman
No abstract provided.
February 2018: Medical Journal of Malaysia
M K Mohd Kamil, C S Ngiu, N Md Isa, Y Yaacob Y, C H Deborah Chew, Z Q Wong, R A Raja Ali
Neuroendocrine neoplasm is an epithelial neoplasm with predominant neuroendocrine differentiation that can arise from many organs in the body. We reported a rare case of gastric neuroendocrine carcinoma which accounts for less than 1% of all gastric tumours that is associated with poor prognosis. The recognition of this rare tumour in early stage is challenging and high suspicious into it might bring to early detection and so forth might improve the prognostication.
February 2018: Medical Journal of Malaysia
G Hong Ong, D K Benjamin Leong
Middle-aortic syndrome is a surgically curable cause of childhood hypertension. Open surgery is traditionally offered but with the advance of medical technology, endovascular approached is available in many country. Failure to control BP in open surgery is as low as 4.1% compares to 13% in endovascular approaches. However, mortality is 4% in open surgery almost 2 times higher than 2.3% in endovascular approach. This article presents a case of 10 years old child treated successfully without complication with endovascular balloon dilatation, as a first case of such disease in East Malaysia...
February 2018: Medical Journal of Malaysia
L S Tan, S Tan
Tuberculosis (TB) is still an endemic disease in Malaysia. Cystic lung disease in post primary tuberculosis is not common. It can occur before, during or after completion of anti-TB treatment. Clinical history and review of serial chest radiograph is paramount to make the diagnosis. This case report highlights an interesting case of a young female patient who developed extensive cystic lung disease during the course of anti-TB treatment and the importance of recognizing this unusual manifestation.
February 2018: Medical Journal of Malaysia
S C Seah, S A L Laili, A Hairiah, A G Ab Rahim
Caesarean scar implantation is one of the rarest form of ectopic pregnancies and most unwanted complication of caesarean scar. However, with the increasing numbers of caesarean section performed, caesarean scar pregnancy (CSP) may be on the rise. The diagnosis is often difficult, but establishing an accurate diagnosis of CSP in the early first trimester is utmost important to prevent its detrimental consequences of uterine rupture and fatal haemorrhage. Hence, we present a case to highlight the role of imaging in diagnosing and managing this condition to prevent its associated high morbidity and mortality...
February 2018: Medical Journal of Malaysia
S S Kho, S K Chan, M C Yong, S T Tie
Tuberculous pleural effusion (TBE) is a common encounter in our region. Up to 50% of patients with TBE will develop residual pleural thickening (RPT) which can lead to functional impairment. However, the need of drainage remains controversial. We report a case of end-stage renal failure patient who presented with right multiloculated tuberculous pleural effusion which was drained via a medical thoracoscope. Patient reports immediate relief of breathlessness post procedure and one month follow up shown significant improvement of RPT...
February 2018: Medical Journal of Malaysia
J Y Eng, S Y Soon, H Y Winnie Ling
Fibrolamellar hepatocellular carcinoma (FL-HCC) is a rare variant of hepatocellular carcinoma. It is commonly reported in the younger population with no underlying chronic liver disease and free of viral Hepatitis B and C. Local recurrence and distant metastasis are common despite better prognosis compared to conventional hepatocellular carcinoma. Complete surgical resection is associated with higher median survival and is the mainstay treatment option for localized FL-HCC. Multi-modality therapies such as TACE can be used to downstage upfront unresectable FL-HCC...
February 2018: Medical Journal of Malaysia
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