1.Multiple oesophago-respiratory fistulae: sequelae of pulmonary tuberculosis in retroviral infection.
Soo Fin LOW ; Chai Soon NGIU ; Erica Yee HING ; Norzailin Abu BAKAR
Singapore medical journal 2014;55(7):e104-6
Pulmonary tuberculosis (PTB) is a common infectious disease worldwide. However, mediastinal tuberculous lymphadenitis complicated by oesophageal involvement and oesophago-respiratory fistula is now uncommon due to improved anti-tuberculous regimes and better general awareness. The overall incidence of acquired oesophago-respiratory fistula due to infection is low, and therefore, the lesion is not often a frontrunner in differential diagnosis. Still, tuberculous oesophago-respiratory fistulae can potentially occur in patients with retroviral disease, as they tend to have atypical and more virulent manifestations. In this study, we report the case of multiple oesophago-respiratory fistulae in a patient with PTB and retroviral disease, and highlight the computed tomography features of these lesions as an atypical presentation of PTB in retroviral disease. Clinicians should suspect oesophago-respiratory fistulae if patients present with Ono’s sign, and remain particularly vigilant for patients with underlying PTB and retroviral disease, as early diagnosis and treatment could help to reduce mortality.
Adult
;
Diagnosis, Differential
;
Esophagus
;
physiopathology
;
Fistula
;
diagnosis
;
Humans
;
Lung
;
pathology
;
Male
;
Radiography, Thoracic
;
Retroviridae
;
metabolism
;
Tomography, X-Ray Computed
;
Trachea
;
physiopathology
;
Treatment Outcome
;
Tuberculosis, Lymph Node
;
Tuberculosis, Pulmonary
;
complications
;
diagnosis
2.Accuracy of ultrasound versus computed tomography urogram in detecting urinary tract calculi
Salinawati Bakin ; Erica Yee Hing ; Fam Xeng Inn ; Zulfiqar Mohd Annuar
The Medical Journal of Malaysia 2015;70(4):238-241
Aim: To determine the (i) sensitivity and specificity of
ultrasound (USG) in the detection of urinary tract calculi, (ii)
size of renal calculi detected on USG, and (iii) size of renal
calculi not seen on USG but detected on computed
tomography urogram (CTU).
Methods: A total of 201 patients’ USG and CTU were
compared retrospectively for the presence of calculi.
Sensitivity, specificity, accuracy, positive predictive value
and negative predictive value of USG were calculated with
CTU as the gold standard.
Results: From the 201 sets of data collected, 59 calculi were
detected on both USG and CTU. The sensitivity and
specificity of renal calculi detection on USG were 53% and
85% respectively. The mean size of the renal calculus
detected on USG was 7.6 mm ± 4.1 mm and the mean size of
the renal calculus not visualised on USG but detected on
CTU was 4 mm ± 2.4 mm. The sensitivity and specificity of
ureteric calculi detection on USG were 12% and 97%
respectively. The sensitivity and specificity of urinary
bladder calculi detection on USG were 20% and 100%
respectively.
Conclusion: This study showed that the accuracy of US in
detecting renal, ureteric and urinary bladder calculi were
67%, 80% and 98% respectively.
Calculi
;
Urinary Calculi
3.Renal doppler assessment in differentiating obstructive from non-obstructive hydronephrosis in children
Nadzri Misni ; Erica Yee Hing ; Hamzaini Abdul Hamid ; Faizah Mohd Zaki ; Aini AbAziz ; Kanaheswari Yoganathan ; Zulfiqar Mohd Annuar
The Medical Journal of Malaysia 2015;70(6):346-350
background: to determine the usefulness of Doppler
ultrasound measurement of resistive index (RI) in
differentiating obstructive from non-obstructive
hydronephrosis in children.
Methods: From August 2011 to November 2012, renal
Doppler assessments of the intra-renal renal arteries were
performed on 16 children (19 kidneys) with congenital
hydronephrosis. the independent t-test was used to
assess for significant difference in RI values between those
with obstructive hydronephrosis (6 kidneys) and those with
non-obstructive hydronephrosis (13 kidneys) as determined
by dynamic renal scintigraphy. the assessor was blinded to
the clinical findings and scintigraphy results.
Results: RI was significantly different between obstructive
and non-obstructive hydronephrosis. Obstructive
hydronephrosis returned higher RI values, with mean RI of
0.78. Mean RI in non-obstructive hydronephrosis was 0.70,
and the difference was significant (p <0.05). the sensitivity
and specificity of Doppler ultrasound were 100% and 53%
respectively.
conclusion: Doppler ultrasound measurement of resistive
index is useful in differentiating obstructive from nonobstructive
hydronephrosis and provides an alternative
non-ionizing investigation other than dynamic renal
scintigraphy.
4.Sonographic nomogram of paediatric renal size in Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
Leong Yuh Yang ; Kanaheswari Yoganathan ; Faizah Mohd Zaki ; Erica Yee Hing ; Nik Azuan Nik Ismail ; Nik Farhan Nik Fuad ; Hamzaini Abdul Hamid
The Medical Journal of Malaysia 2020;75(2):130-135
Introduction: A person’s childhood is an important period of
growth, and also one’s most vulnerable, as one can be
exposed to various pathologies, for example those that
could affect the growth of one’s kidney. Asians are
physiologically different from Caucasians, and the
nomogram renal size obtained from a Western population
(mostly of Caucasians) is not be suitable for representing
Asian children. As such a nomogram on paediatric renal size
derived from Malaysia is needed.
Methods: A total of 109 (64 males and 45 females) aged 0-12
in Pusat Perubatan Universiti Kebangsaan Malaysia
(PPUKM) took part in this study. They underwent
ultrasonography of both kidneys, and their demographic
and anthropometric data were collected. The mean and
standard deviations of the renal length and renal volume
according to their age groups was calculated, and the final
data was compared to the ones reported by Rosenbaum et
al. (1984).
Result: Body weight and Body Surface Area (BSA) of the
children reported the strongest correlation with renal size.
Significant differences were found between local and the
data from Rosenbaum et al (1984). A nomogram on
paediatric renal size based on children in PPUKM was then
created.
Discussion: Ultrasonography is regarded as the standard
method for determining renal size. Body weight and BSA
were both strongly correlated with renal size. It was shown
that the widely used nomograms derived from data obtained
from Caucasian was not suitable to represent the population
of Malaysian children.