1.Anti N-Methyl-D-Aspartate Receptor Encephalitis with Ovarian Teratoma: A Dilemma in Diagnosis
Lee CL ; Zainuddin AA ; Abdul Karim AK ; Yulianty A ; Law ZK ; Md.Isa N ; Nor Azlin MI
Journal of Surgical Academia 2016;6(1):66-69
We report a rare case of altered mental status in a young patient with immature ovarian teratoma. A 22-year-old
woman presented with seizures, hallucination, amnesia and orofacial dyskinesia. Examination and investigation
revealed an ovarian massand asalphing-oophorectomy was performed. The histopathological examination result
showed an immature teratoma grade 2 with thepresence of immature primitive glial tissue. Her CSF N-Methyl-DAspartic
acid receptor (Anti-NMDAR) antibodytest was positive. N-Methyl-D-Aspartic acid receptor antibody
associated limbic encephalitis is an autoimmune antibody-mediated neuropsychiatric disorder. Resection of the
tumour and immunotherapy resulted in full recovery.
Anti-N-Methyl-D-Aspartate Receptor Encephalitis
2.Suicidal ideation amongst epilepsy patients in a tertiary centre
RA Rani ; R Razali ; R Hod ; K Mohamad ; S Azmin ; WNNW Yahya ; R Sahathevan ; R Remli ; ZK Law ; NM Ibrahim ; HJ Tan
Neurology Asia 2014;19(2):129-136
Background and Objective: Epilepsy and depression are interlinked and lead to an increased risk of suicidal ideation and suicide. Although depression is a significant risk factor for suicidal ideation in epilepsy patients, epilepsy itself is independently associated with suicidal ideation. There are various other factors related to epilepsy that further increase this risk. Methods: We conducted a study of suicidal-ideation amongst epilepsy patients in our centre. Demographic data and clinical history were obtained while suicidal ideation was determined using the Columbia Suicide Severity Rating Scale (C-SSRS). Beck’s Depression Inventory–II (BDI-II) was used to identify presence of depression. Results: We recruited 80 patients with epilepsy and an equal number of controls. Epilepsy patients were more likely to be depressed with a mean BDI-II score of 9.09 ±6.48 compared to controls who has a mean score of 5.56 ±4.56. The proportion of epilepsy patients with suicidal ideation was 33.75% vs. 5.00% in the control group (p<0.001). Epilepsy patients were 9.68 times more likely to have suicidal ideation compared to controls: OR 9.68 (95% CI 3.19, 29.28). Amongst epilepsy patients, those with suicidal ideation were more likely to be on 3 or more anti-epileptic drugs (10.00% vs. 6.25%, p=0.016), with a higher seizure frequency (11.25% vs. 2.50%, p=0.004) and higher incidence of previous head surgery (10.00% vs. 5.00%, p=0.022). Conclusion: Suicidal ideation was significantly prevalent amongst epilepsy patients especially in patients with frequent seizures, use of > 3 anti-epileptic drugs or prior head surgery. Our findings suggest that assessment of suicidal ideation is pertinent in high-risk epilepsy patients and should be routinely carried out in the clinical setting.
3.Nerve Conduits For Nerve Regeneration: An In-Vitro Study Of Electrospun PLGA Nanofibers On Collagen
Mohd Khalid S ; Khairunnisa R ; Izzat AY ; Shalimar A ; Mohamed Haflah NH ; Ng MH ; Ohnmar H ; Naicker AS ; Azmi B ; Ruszymah BHI ; Law ZK
Malaysian Orthopaedic Journal 2018;12(Supplement A):1-