1.A case of ear canal black pigment foreign body mimicking a melanoma
The Medical Journal of Malaysia 2015;70(3):198-199
SUMMARY
Melanoma of the ear canal is extremely rare; due to its
hidden area, most would present late in their history. We
present the first case reported, of a black pigment foreign
body mimicking a melanoma in the external auditory canal.
A 14 year old Chinese male presented with right sided
otalgia and itch. Otoscopic examination revealed an
irregular black naevus in the right auditory canal. An intraoperative
excision showed a black pigment foreign body
giant cell reaction. Clinicians should be aware of the
possibility of a foreign body granuloma of the ear canal that
might mimic a melanoma.
Melanoma
;
Foreign Bodies
2.Food allergy and allergic rhinitis in 435 asian patients – A descriptive review
Kathleen A Pang ; Kenny P Pang ; Edward B Pang ; Tan Yuk Ngi Cherilynn ; Yiong Huak Chan ; Jin Keat Siow
The Medical Journal of Malaysia 2017;72(4):215-220
Objective: To describe the prevalence of food allergy in
Asian patients with allergic rhinitis.
Study Design: A non-randomized prospectively collected
patients over a three year period, with complaints of nose
congestion, rhinorrhea and/or nasal discharge.
Results: There were 435 patients enrolled, 213 children and
222 adults. The children group had a high prevalence of
allergen specific IgE to Dermatophagoides pteryonysinus
(70%), Dermatophagoides farina (69%), and Blomia
tropicalis (55%); followed by dogs (32%), cats (19%) and
cockroaches (19%). In the children food allergy category, the
top three allergens were egg white (54%), milk (31%) and
soya bean (13%). The adult group had results of
Dermatophagoides pteryonysinus (71%), Dermatophagoides
farina (72%), and Blomia tropicalis (59%); the adult food
allergy category, the top 3 allergens were egg white (13%),
milk (6%) and soya bean (5%). There was a statistically
significant difference in the child and adult group for Dust,
D. pteryonysinus, D. farina, B.tropicalis, egg white, wheat,
gluten and soya bean. In the age specific child groups, there
was an increased in egg food allergy levels, with a peak at
the age of five-nine years old and decreasing thereafter
(p=0.04). In the children group, the mean Total Nasal
Symptom Score (TNSS) was 10.3 (range of 7 to 13); the adult
group was similar, with a mean TNSS of 9.8 (range 5 to 12).
Conclusion: The prevalence of food allergy in paediatric
patients with allergic rhinitis is fairly high and should be
considered when treating these children.
3.SLEEP-GOAL: A multicenter success criteria outcome study on 302 obstructive sleep apnoea (OSA) patients
Kenny P. Pang ; Peter M Baptista J ; Ewa Olszewska ; Itzhak Braverman ; Marina Carrasco Llatas ; Srivinas Kishore ; Sudipta Chandra ; Hyung Chae Yang ; Yiong Huak Chan ; Kathleen Ann Pang ; Edward Benjamin Pang ; Brian Rotenberg
The Medical Journal of Malaysia 2020;75(2):117-123
Objective: To demonstrate SLEEP-GOAL as a more holistic
and comprehensive success criterion for Obstructive Sleep
Apnoea (OSA) treatment.
Methods: A prospective 7-country clinical trial of 302 OSA
patients, who met the selection criteria, and underwent
nose, palate and/or tongue surgery. Pre- and post-operative
data were recorded and analysed based on both the Sher
criteria (apnoea hypopnea index, AHI reduction 50% and
<20) and the SLEEP-GOAL.
Results: There were 229 males and 73 females, mean age of
42.4±17.3 years, mean BMI 27.9±4.2. The mean VAS score
improved from 7.7±1.4 to 2.5±1.7 (p<0.05), mean Epworth
score (ESS) improved from 12.2±4.6 to 4.9±2.8 (p<0.05),
mean body mass index (BMI) decreased from 27.9±4.2 to
26.1±3.7 (p>0.05), gross weight decreased from 81.9±14.3kg
to 76.6±13.3kg. The mean AHI decreased 33.4±18.9 to
14.6±11.0 (p<0.05), mean lowest oxygen saturation (LSAT)
improved 79.4±9.2% to 86.9±5.9% (p<0.05), and mean
duration of oxygen <90% decreased from 32.6±8.9 minutes
to 7.3±2.1 minutes (p<0.05). The overall success rate (302
patients) based on the Sher criteria was 66.2%. Crosstabulation of respective major/minor criteria fulfilment,
based on fulfilment of two major and two minor or better, the
success rate (based on SLEEP-GOAL) was 69.8%. Based
solely on the Sher criteria, 63 patients who had significant
blood pressure reduction, 29 patients who had BMI
reduction and 66 patients who had clinically significant
decrease in duration of oxygen <90% would have been
misclassified as “failures”.
Conclusion: AHI as a single parameter is unreliable.
Assessing true success outcomes of OSA treatment,
requires comprehensive and holistic parameters, reflecting
true end-organ injury/function; the SLEEP-GOAL meets
these requirements