To report a rare case of left orbital rhabdomyosarcoma(RMS) presented with severe proptosis and fungating mass in an elderly patient.A 66 year Malay lady presented with severe proptosis and fungating mass in the left eye preceded by epistaxis for eight months. Biopsy showed histological features of alveolar RMS.

AIM: To report a case of left orbital abscess resulted from frontal sinus mucocele.METHODS: Case report.RESULTS: A 30-year-old Malay lady presented with left eye pain and swelling for three days associated with impairment of vision and proptosis. CT scan showed left frontal sinus mucocele that extended to the left orbit. Surgical drainage resulted in dramatic improvement of proptosis and vision.CONCLUSION: Orbital abscess can result from frontal sinus mucocele in patient without previous history of paranasal sinuses disease.

This is a prospective randomized clinical trial to compare use of a combination of periarticular drug injection with patientcontrolled analgesia (PCA) to PCA alone in post-total knee arthroplasty (TKA). Thirty patients who were admitted for unilateral total knee arthroplasty were selected randomly into an Injection group or a Standard group. The periarticular injection contained Ropivacaine, Ketorolac and Adrenaline, given intra-operatively. The mean amount of opioid used was 22.87 mmol/L in the Injection group as compared to 39.78 mmol/L in the Standard group (p = 0.026). The Injection group had lower pain score at rest and during exercise (p=0.021, p=0.041, respectively), as well as better return to function (p=0.026) and shorter hospital stay (6.1 days, Injection; 7.5 days, Standard, p=0.027). Overall, the group receiving periarticular drugs injection had less pain, less narcotic usage, earlier return to function, similar experience of adverse effects and shorter hospital stays.

Patch testing has been accepted as the most important investigative technique of assessing allergic contact dermatitis (ACD) and identifying the contact allergens. The epidemiology of ACD differs in different geographic region as the environmental allergens vary in different populations. In this study 59.8% of the patients had a positive patch test reaction to one or more allergens. The prevalence of ACD was 64.7% in women and 51.4% in men. The commonest causes of ACD were nickel (30.4%), fragrance mix (18.16%) and balsam of Peru (6.73%).

Composite resins Amaris is claimed to have hydrophobic effect which minimizes the staining intake. This study is to investigate the colour stability of Amaris compared to Filtek Z250 in coffee solution. Sixty discs of composite resins Filtek Z250 (3M ESPE) and Amaris (Voco) with diameter of 5mm and depth of 2mm were fabricated by packing in a drinking straw and sectioned with hard tissue cutter (Exakt, Japan). The surfaces of the specimens were polished with Sof-Lex disc before each group of the samples is immersed in coffee solution. They were kept in the solution for 4 days at 370C and assessed at the period of 2 hours, 1 day, 2 days, 3 days, and 4 days. The staining was assessed visually and recorded using Lobene (1968) Stain Index and score was given accordingly. The colour changes of both groups were not statistically significant (p<0.05) for period of 2 hours, 1day, 2 days, 3 days and 4 days All groups showed the score values increased gradually with time. Both composite resins have similar colour stability in coffee solutions.

Objective: This report aims to determine the clinical manifestations and management of patients with superior semicircular canal dehiscence syndrome (SSCDS). Methods: Design: Case series Setting: Tertiary hospitals and private clinics Participants: Out of 30 patients with vestibular vertigo or otologic symptoms, 14 patients were diagnosed with SSCDS based on high resolution computed tomographic scan (HRCT). The demographic features, incidence of specific signs and symptoms and management of these patients were described, including the audiograms, vestibular evoked myogenic potential (VEMP) responses and ancillary tests. Results: Vertigo was the most common vestibular symptom of SSCDS. Tullio phenomenon was elicited in 50% of patients with confirmed dehiscence on HRCT scan. Low frequency (250 Hz and 500 Hz) air-bone gap was noted in 21.4% of patients. Lowered VEMP responses were also noted in 66.7% of patients with confirmed SSCDS. Severity of symptoms may determine its management. Conclusion: The diagnosis of SSCDS does not conform to a specific clinical presentation or audiologic result and good clinical correlation is needed in order to raise suspicion of the disease and prompt the clinician to order confirmatory imaging by computed tomographic scan or magnetic resonance imaging. The presence of this syndrome in a proportion of children that is greater than previously reported needs further study as these children may be genetically predisposed to have thinned out superior semicircular canals that eventually become dehisced albeit at an earlier age.

A fourteen years old Malay boy was involved in a motor vehicle accident and suffered multiple injuries. The patient was referred to ophthalmology for right periorbital haematoma, ocular examination was normal but proptosis of right eye was detected which was later associated with increase in the intraocular pressure (IOP). Direct carotid cavernous sinus fistula (CCF) was diagnosed by angiography and treated with embolization.

Although schistosomicidal drugs and other control measures exist, the advent of an efficacious vaccine remains the most potentially powerful means for controlling this disease. In this study, native fatty acid binding protein (FABP) from Fasciola gigantica was purified from the adult worm's crude extract by saturation with ammonium sulphate followed by separation on DEAE-Sephadex A-50 anion exchange chromatography and gel filtration using Sephacryl HR-100, respectively. CD1 mice were immunized with the purified, native F. gigantica FABP in Freund's adjuvant and challenged subcutaneously with 120 Schistosoma mansoni cercariae. Immunization of CD1 mice with F. gigantica FABP has induced heterologous protection against S. mansoni, evidenced by the significant reduction in mean worm burden (72.3%), liver and intestinal egg counts (81.3% and 80.8%, respectively), and hepatic granuloma counts (42%). Also, it elicited mixed IgG1/IgG2b immune responses with predominant IgG1 isotype, suggesting that native F. gigantica FABP is mediated by a mixed Th1/Th2 response. However, it failed to induce any significant differences in the oogram pattern or in the mean granuloma diameter. This indicated that native F. gigantica FABP could be a promising vaccine candidate against S. mansoni infection.
Animals ; Antibodies, Helminth/immunology ; Fasciola/*chemistry ; Fatty Acid-Binding Proteins/*administration & dosage/immunology/isolation & purification ; Female ; Helminth Proteins/*administration & dosage/immunology/isolation & purification ; Humans ; Immunization ; Mice ; Mice, Inbred Strains ; Schistosoma mansoni/immunology/*physiology ; Schistosomiasis mansoni/immunology/parasitology/*prevention & control

Chlamydia trachomatis (CT) infections are among the sexually transmitted diseases known to increase the risk for human immunodeficiency virus infection. Serum samples from 34 consenting AIDS patients which attended the Government-approved Antiretroviral Treatment (ART) Facility at the National Institute for Pharmaceutical Research and Development (NIPRD), Abuja between April 2005 and March 2006 were screened by enzyme immunoassay (EIA) for the presence of anti-CT antibodies using ImmunoComb® Chlamydia Bivalent IgG Test kit (Orgenics, Israel). Anti-CT antibodies were detected in ten (29.4%) of the thirty-four patients tested. The detection rate was higher among the females (33.3%) than the males (23.1%). Patients of the age group 31-45 years had the highest detection of anti-C. trachomatis antibodies, followed by those of age group 16-30 years. The result of the present study suggests the presence of anti-CT antibodies in AIDS patients, and reinforces the need for routine screening for anti-CT antibodies as a necessary intervention to reduce the burden of chlamydial diseases and to reduce the risk of HIV and its spread in Nigeria. The outcome of this study also provides justification for the possible inclusion of anti-chlamydial agents in the National AIDS Management Plan to treat associated C.trachomatis infections.

Acral melanoma has been reported to have distinctive clinical presentation and ethnic distribution compared to other histological types of malignant melanoma. Acral melanoma also exhibits distinctive focused gene amplifi cations, including cyclin D1 overexpression. We reviewed archived histological material of malignant melanoma in the Sarawak General Hospital from year 2004 to 2010. 43 tumours, comprising 28 acral melanoma and 15 non-acral melanoma, had suffi cient material to be included in the study. The majority (36%) of acral melanoma tumours occurred in the heel. The tumours were analyzed for cyclin D1 expression by immunohistochemistry. 68% of acral melanoma were cyclin D1 positive compared to a positivity of 33% in non-acral tumours. This difference was statistically signifi cant (p <0.05). This fi nding may improve the histological diagnosis of acral melanoma and detection of positive resection margins.