1.Acute haemorrhagic oedema of infancy with bullae and koebnerisation
Mohd Sazlly Lim S ; Shamsudin N
Malaysian Family Physician 2014;9(2):55-57
A 5-month-old Malay boy presented with purpuric papules and plaques on the face and extremities accompanied by fever, coryzal symptoms and bilateral lower limb oedema. There were also bullous linear purpuric lesions on the right upper limb. Blood and culture tests were normal.
Histopathological tests showed leucocytoclastic vasculitis, confirming the diagnosis of acute
haemorrhagic oedema of infancy. The patient achieved complete recovery after 2 weeks with no recurrence.
Blister
;
Purpura
;
Infant
;
Erythema elevatum diutinum
2.Atypical Thyrotoxic Psychosis with Seizure: A Case Report
The International Medical Journal Malaysia 2012;11(1):55-58
Thyrotoxicosis results in alteration in functioning of nervous system in some patients. However, these mental
disturbances may be severe in rare cases in the form of manic-depressive, schizoid or paranoid reaction. The
pathophysiological basis of these nervous system findings is not well understood.
3.Implementing standard setting into the Conjoint MAFP/FRACGP Part 1 examination – Process and issues
Chan SC ; Mohd Amin S ; Lee TW
Malaysian Family Physician 2016;11(2 & 3):2-8
The College of General Practitioners of Malaysia and the Royal Australian College of General Practitioners held the first Conjoint Member of the College of General Practitioners (MCGP)/Fellow of Royal Australian College of General Practitioners (FRACGP) examination in 1982, later renamed the Conjoint MAFP/FRACGP examinations. The examination assesses competency for safe independent general practice and as family medicine specialists in Malaysia. Therefore, a defensible standard set pass mark is imperative to separate the competent from the incompetent.
4.Damage control resuscitation: A case of thoraco abdominal impalement
Nur Abdul Karim ; Mohd Amin Mohd Mokhtar ; Izzat Ismail ; Abdul Halim S ; Nor Elayni Borhan
The Medical Journal of Malaysia 2016;71(2):77-78
Damage Control Resuscitation and Surgery is the concept of
controlled hypotension, haemostatic resuscitation and
abbreviated surgical procedures following severe trauma;
the practice of which has resulted in improved mortality and
morbidity. We describe a rare case of thoraco-abdominal
impalement successfully managed based on the concept of
Damage Control Resuscitation.
Hypotension
5.A case of chronic myeloid leukaemia in blast transformation with leukemic ascites
Mohd Ridzuan Mohd Said ; Ernie Yap ; Wan Fariza Wan Jamaluddin ; Fadilah S Abdul Wahid ; Salwati Shuib
The Medical Journal of Malaysia 2016;71(2):85-87
Chronic Myeloid Leukaemia (CML) is a disease
characterised by a distinctive marker that is the Philadelphia
Chromosome and an ability to transform into blast phase,
which confers a poor prognosis. The median survival was
reported to be between three to six months in correlation to
blast phase. Extramedullary involvement with CML to sites
such as pleural, meningeal and bones have been reported.
We report a case of 41-year-old man who was diagnosed
with CML in blast phase and presented with ascites.
Ultrasound of abdomen showed coarse echotexture of liver
suggestive leukaemic infiltration to the liver. The liver profile
was severely deranged and associated with coagulopathy.
Flow cytometry analysis of the peritoneal fluid revealed
presence of myeloblasts consistent with CML in blast crisis
with leukaemic ascites. Bone marrow biopsy also confirmed
disease transformation. He received standard induction
chemotherapy for acute myeloid leukaemia with dose
modifications based on liver enzymes performance. Our
case highlights an unusual presentation of CML in blast
crisis with leukaemic ascites and the challenges in
managing cytotoxic treatments due to the liver infiltration.
Leukemia, Myeloid, Acute
6.Drivers’ Knowledge And Attitudes Towards Child Restraint System (Crs) Usage
Noor Faradila P ; Baba MD ; Mohd Syazwan S ; Azhar H ; Mohd Rasid O
Malaysian Journal of Public Health Medicine 2018;18(Special Volume (2)):66-72
Child restraint system (CRS) can protect children in the event of crash and reduce the severity of injuries. As such, it is crucial to understand the prevalence of CRS usage and knowledge attributes on CRS usage among drivers. This study aims to assessdrivers’ knowledge on CRS usage.A semi-structured questionnaire was developed and pilot tested to verify its validity and reliability. The questionnaireaddressesdrivers’ knowledge about CRS currently available in the Malaysian market, the types of restraints used and views on fitting restraints to passenger vehicles. Seventy four percentfrom 500 respondents cited that they are usingor theyhave used CRS,64% knowabout CRS and its function, and 43% areawareof ISOFIX. In short, majority of the respondents are aware of CRS use and functions. Awareness and education program should berigorously introduced to public towards the implementation of the CRS law.
Child restraint system
;
children passenger safety
;
road traffic accident
;
child injury
8.A Pure Nongestational Choriocarcinoma of Ovary: Sharing Experience in Sabah
Mohd Faizal A ; Dianie DJK ; Suguna S ; Soon R ; Moharzudi M
Journal of Surgical Academia 2015;5(1):51-53
A pure ovarian choriocarcinoma is a very rare disease which can be either pregnancy related (gestational), may not
be related (non-gestational), or commonly correlated with different type of germ cell; teratocarcinoma,
dysgerminoma or undifferentiated carcinoma. A pure non-gestational primary ovarian choriocarcinoma is
astronomically uncommon and we recorded such condition in 14-year-old teenage girl’s ovary. An abdominal
operative procedure with the help of a careful histopathology examination revealed choriocarcinoma in absence of
other type of germ cell element. Multiple courses of Etoposide/Methotrexate/Actinomycin-D (EMA) regime of
chemotherapy were shown to be effective in this case.
Choriocarcinoma
9.Distance between Midline and Vertebral Artery Groove of Atlas – A Real Aid to the Neurosurgeon
Mukesh S, Prabhat G, Mohd Salahuddin A, Kumar SR
Journal of Surgical Academia 2014;4(1):26-29
The knowledge of the relationship of the vertebral artery with the atlas is very important, in order to avoid any injury
to the vertebral artery, during surgeries in the craniovertebral region. Different researchers have measured the
distance of the vertebral artery from the midline along the posterior arch of atlas (oblique distance), but some authors
have measured the perpendicular distance of vertebral artery from the midline. Usually, it is the perpendicular
distance along which the surgeons are exploring in this region. Hence, the present study was planned to study and
compare both oblique and perpendicular distances of the vertebral artery from the midline and find out statistical
differences between these two parameters. It was carried out on 30 atlas vertebrae of Indian origin. The oblique and
perpendicular distances of vertebral artery groove from midline and the thickness of vertebral artery groove were
measured. The results suggest that dissection on the posterior aspect of the arch of atlas should remain 17.00 mm
lateral to the midline and dissection on the superior aspect of the arch of atlas should remain 8.00 mm from the
midline to prevent injury to the vertebral artery. It was also observed that “oblique distances of vertebral artery
groove from the midline to the medial margin of inner and outer cortex are larger than the corresponding
perpendicular distances from the midline”. Although, the differences of oblique and perpendicular distances are not
statistically significant but it may be clinically significant for the surgeons operating in the craniovertebral region.
Hence, it is concluded that the surgeon should be aware of both the distances while operating in the craniovertebral
region to avoid any iatrogenic injury to the vertebral artery.
10.A Study on the Morphometric Asymmetry of Atlas Vertebrae
Mohd Salahuddin A ; Mukesh S ; Binaya KB ; Nilotpal C
Journal of Surgical Academia 2016;6(1):18-24
The commonly used examination procedures of the upper cervical spine depend upon the symmetry for comparison
and interpretation of joint functions. If symmetry is not normal, then these assessments may mislead the examiners,
allowing them implementation of incorrect treatment plans. Objectives of this study are to explore the possibility that
asymmetry is more common than symmetry and, if it is true, to find out the effects of asymmetry on the
biomechanics of these joints. The study was carried out on 30 atlas vertebrae of cadavers of Indian origin. The
different intra-atlas distances were measured on both sides by digital vernier calliper. All the parameters studied
showed statistically significant differences between the right and left side i.e. a p value of < 0.05. The anteroposterior
diameter of the foramen transversarium, the transverse diameter of the foramen transversarium, the distance
from the midline to medial edge of the vertebral artery groove (inner as well as outer cortex) and the length of the
superior articular facets were more on the right side as compared to the left side. The breadth as well as the length of
the inferior articular facet, the breadth of the superior articular facet and the difference of posterior arch thickness at
the site of vertebral artery groove were more on the left side as compared to the right side. These differences may be
explained by the handedness of an individual, which influences the intra-osteal asymmetry in a characteristically
distinct manner, which needs to be confirmed or refuted in a further study.
Cervical Atlas