Background Cutaneous tuberculosis (TB) is a form of extrapulmonary tuberculosis. Diagnosis of cutaneous TB is often difficult because of the diverse clinical presentations. The positive yields from cultures are often low. To describe the demographic, clinical, histopathological and bacteriological aspects of cutaneous TB. Materials and Methods This retrospective review looked at cases of cutaneous tuberculosis treated at the Respiratory and Dermatology unit, Penang Hospital from 1996 to 2007. Data were analysed with SPSS 13.0 version. Results A total of 23 cases of cutaneous tuberculosis were reviewed. The male to female ratio was 2.3 to 1. The mean age was 37.7 ± 20.7 years. There were 10 Malays, 9 Chinese, 2 Indians and 2 Indonesian. The types of cutaneous tuberculosis observed were lupus vulgaris (47.8%), tuberculides (17.5%), tuberculosis verrucosa cutis (13.0%), scrofuloderma (13.0%) and primary inoculation TB (8.7%). 43.5% of patients had systemic involvement. Mantoux tests were positive in 85.0% of cases. Skin biopsies were performed in 91.3% of patients and 71.4% of them showed classical histopathologic findings suggestive of tuberculosis. Mycobacterium tuberculosis was isolated in the culture from 28.6% of patients. Localized diseases were found more often in BCG-vaccinated individuals. Regional lymphadenopathy was noted more often in patients with disseminated disease. No correlation was found between Mantoux reactivity and the extent of disease. Conclusion Lupus vulgaris was the commonest form of cutaneous tuberculosis. Cultures were positive in only a small proportion of patients. Almost half of our patients had systemic involvement. The presence of regional lymphadenopathy often indicates disseminated disease. Patients without BCG vaccination were at higher risk of disease dissemination.

Reports of combined candidal and herpetic esophagitis in immunocompetent states are rare and sporadic. A 44-year-old previously healthy lady presented with a one week history of progressive dysphagia, odynophagia and fever. Esophagogastroduodenoscopy (EGD) showed extensive desquamation of the entire esophagus except for distal 4 cm. Histopathological examination revealed ulcerated and inflamed squamous epithelium with the margin of ulcer showing a few overhanging squamous cells with dense eosinophilic cytoplasm, multinucleated and faceted nuclei with glassy chromatin, and an occasional Cowdry type A intranuclear inclusion bodies. Few candidal spores were seen in the underlying stroma. Intravenous acyclovir, fluconazole and pantoprazole were initiated. Oral analgesics were given for pain relief. She was treated for a total of 14 days. She showed significant improvement and was tolerating oral intake after discharge. The patient was asymptomatic with no evidence of recurrence at a 2-month follow-up.
Adult ; Antifungal Agents ; therapeutic use ; Antiviral Agents ; therapeutic use ; Candidiasis ; diagnosis ; drug therapy ; microbiology ; Esophagitis ; diagnosis ; drug therapy ; microbiology ; virology ; Esophagus ; microbiology ; pathology ; virology ; Female ; Herpes Simplex ; diagnosis ; drug therapy ; virology ; Humans ; Inclusion Bodies, Viral ; Spores, Fungal ; Treatment Outcome

The management of pink pulseless limbs in supracondylar fractures has remained controversial, especially with regards to the indication for exploration in a clinically well-perfused hand. We reviewed a series of seven patients who underwent surgical exploration of the brachial artery following supracondylar fracture. All patients had a non-palpable radial artery, which was confirmed by Doppler ultrasound. CT angiography revealed complete blockage of the artery with good collateral and distal run-off. Two patients were more complicated with peripheral nerve injuries, one median nerve and one ulnar nerve. Only one patient had persistent arterial constriction which required reverse saphenous graft. The brachial arteries were found to be compressed by fracture fragments, but were in continuity. The vessels were patent after the release of obstruction and the stabilization of the fracture. There was no transection of major nerves. The radial pulse was persistently present after 12 weeks, and the nerve activity returned to full function.
Humerus ; Fractures, Bone

Introduction: Various phantom with varied materials has been proposed to replace the human body. Besides, there is always a demand to use the local material as a phantom material, which is readily available and inexpensive. Wood is usually preferred because it is multifunction, environmentally friendly, low in toxic, inexpensive, as well as easy to use and prepare. Previous studies have found that Rhizophora spp. is a suitable natural source material and has been suggested due to its comparable dosimetric properties to commercial phantom. Methods: In this study, fabricated Rhizophora spp. particleboards phantom was opted as a solid-equivalent phantom medium at low energy photon beams using Gafchromic film x-ray quality assurance 2 (XRQA2). Additionally, the characteristics of XRQA2 film in the diagnostic energy range were generated. Results: Interestingly, the density of the fabricated Rhizophora spp particleboards was observed to have the same density with the water equivalent material (ρ= 1.00 g.cm-3) and has shown to have loosened agreement with PDD of water phantom at approximately 25% of the dose error. Also, further analysis using XRQA 2 film showed that energy was independent at different ranges. Conclusion: The analysis of fabricated Rhizophora spp particleboards undertaken here has extended our knowledge of the possibility of manufacturing cost-effective water equivalent phantom by using binder-less particleboard from Rhizophora spp. Therefore, a definite need for smaller interspacing particles should be considered to elevate the potential of Rhizophora spp particle boards as water equivalent materials.

Introduction: Recently mobile communication technology had tremendous advances and became the priority for most of the users with some opponent opinions that highlight the accountability and the privacy issues in using these messaging applications. WhatsApp is scored to be the first top used messaging application worldwide that is used in 180 countries by about 1.5 billion population. This research aims to determine the staff reflections regarding the WhatsApp usage for organizational communication. Methods: This study is implied among the staff at the medical and health life science cluster, Management and Science University (MSU), Malaysia. A questionnaire was distributed to all the staff through an online google form. Responses were analysed by the ‘Statistical Package for Social Sciences’ (SPSS) Version 24.0. Results: Results showed that all the staff responded (100%) are using WhatsApp for organizational communication with variable degrees of satisfaction; 8.1% are extremely satisfied, 61.3 % are satisfied, 12.9% are not satisfied and 16.1 % are extremely not satisfied. Their level of satisfaction is significantly affected by the respondent’s age, benefit of usage, and the time of messaging. Conclusion: To ensure effectiveness of communication through WhatsApp, it should be through official groups and the organization should put specific announced rules for the time of usage and the content of messages to be posted to all members.