1.Value of MRI in diagnosis of giant cell arteritis
Syazarina Sharis Osman ; Amin Ahem
Neurology Asia 2012;17(4):369-372
Giant-cell arteritis is an infl ammatory disease of blood vessels most commonly involving large and
medium arteries of the head, predominately the branches of the external carotid artery. It is a form
of vasculitis. Giant-cell arteritis of the temporal artery is referred to as “temporal arteritis”. Giant
cell arteritis is rare among Asians. Diagnosis is based on American College of Rheumatology (ACR)
classifi cation criteria for giant-cell arteritis with gold standard temporal artery biopsy.1
Blindness is a
feared complication, mostly caused by anterior ischaemic optic neuropathy. High-resolution magnetic
resonance imaging (MRI) has started to play a role in the diagnosis of giant cell arteritis. Evidence
of arteritis involving the superfi cial temporal arteries with mural thickening and even the ophthalmic
arteries can be seen on MRI, which further increase the diagnostic confi dence prior to biopsy.2,3 Optic
perineuritis is a rare association with giant cell arteritis. MRI is required for diagnosis especially for
differentiation from optic neuritis.4 We report a case of giant cell arteritis with optic perineuritis to
demonstrate the role of MRI in the diagnosis.
2.Bio-psychological perspectives of eating disorders and obesity: a revisited
ASEAN Journal of Psychiatry 2008;9(1):33-41
Food is closely related with emotion. It often provides comfort and satisfaction. Some individuals choose to turn to food to curb their negative emotion, resulting in disturbances in
eating patterns, such as overeating which lead to obesity and severely controlling food intake,
which culminate in eating disorders like anorexia nervosa, bulimia nervosa and binge eating.
These disorders are not related to the eating problems per se but often due to underlying or
complicated by psychological factors, namely depression, anxiety, impulse control problems
and personality. The roles of psychological factors in eating disorders and obesity should
therefore not be downplayed. These disorders should be managed comprehensively involving
multiple approaches, including not only biological but also psychological interventions provided by a professional team comprising endocrinologists, psychiatrists, dietitians, exercise
physicians and surgeons.
3.Anorexia nervosa with comorbid borderline personality disorder, major depression and homosexuality in a young Malay man: a case report
ASEAN Journal of Psychiatry 2008;9(2):126-128
We aimed to report the first case of anorexia nervosa in a young Malaysian Malay homosexual man with underlying borderline personality disorder and major depression. Patient and parents were interviewed. The Structured Clinical Interview for DSM IV was used to generate
Axis-I diagnosis. The Hamilton Depressive Rating Scale was used to assess the severity of depression. His parents had marital discord. His father was overinvolved. Regarding anorexia nervosa, he had 163 cm height, 46kg weight and a body mass index (BMI) of 17 kg/m2
. His four limbs had multiple scratch marks. Laboratory test results showed anemia, leukocytosis
and hypoalbuminemia. Family pathology, borderline personality disorder and homosexuality
could be the risk factors of anorexia nervosa in this patient.
4.Anorexia nervosa with comorbid borderline personality disorder, major depression and homosexuality in a young Malay man: a case report
ASEAN Journal of Psychiatry 2007;8(1):126-128
We aimed to report the first case of anorexia nervosa in a young Malaysian Malay homosexual
man with underlying borderline personality disorder and major depression. Patient and
parents were interviewed. The Structured Clinical Interview for DSM IV was used to generate
Axis-I diagnosis. The Hamilton Depressive Rating Scale was used to assess the severity of
depression. His parents had marital discord. His father was overinvolved. Regarding anorexia
nervosa, he had 163 cm height, 46kg weight and a body mass index (BMI) of 17 kg/m2. His
four limbs had multiple scratch marks. Laboratory test results showed anemia, leukocytosis
and hypoalbuminemia. Family pathology, borderline personality disorder and homosexuality
could be the risk factors of anorexia nervosa in this patient.
6.Internal Fixation of Unstable Pelvic Ring Injuries via the Modified Stoppa Approach
Malaysian Orthopaedic Journal 2011;5(1):30-33
Background: The modified Stoppa approach was first described in 1993 by Hirvensalo as an alternative to the ilioinguinal approach for treatment of pelvic ring fracture. Methods: This is a retrospective study of 5 patients with unstable pelvic fracture treated with internal fixation using the modified Stoppa approach. Residual displacement of the pelvic ring was measured and graded using the methods described by Matta and Lindahl. Functional outcomes were assessed using the modified Merle D Aubigne and Pos
Orthopaedic
7.Coping Styles and Clinical Factors in Relation to Quality of Life among Patients with Schizophrenia
Mohd Badli M ; Osman CB ; Ainsah O
Medicine and Health 2008;3(1):14-21
This is a cross sectional study examining quality of life in relation to coping styles among
patients with Schizophrenia (N=92) in remission, from June 2002 to December 2002.
Remission state is determined by Brief Psychiatric Rating Scale (BPRS). The psychiatric
diagnosis was made by treating psychiatrist using the Clinical Interview Schedule for the
DSM-IV Diagnosis. They are subsequently asked to complete demographic and clinical
data questionnaire and followed by 36-item short-form health survey (SF-36) of the
Medical Outcome Study (MOS) for the assessment of quality of life and the Coping
Inventory for Stressful Situation (CISS). The QOL in term of overall mental health among patients with schizophrenia was significantly and positively associated with ethnic group
(p<0.05), employment status, type of antipsychotic (p<0.05) and number of admission
(p<0.05). Being Chinese and employed are associated with better QOL in term of overall
mental health. The commonly used coping style among patients with Schizophrenia is the
distraction component of avoidance-oriented coping. The task-oriented coping was
significantly and positively correlated with quality of life in term of mental component.
There was a negative correlation between the emotion-oriented coping and all the domain
of the quality of life. In conclusion, better quality of life is positively correlated with taskoriented
coping and inversely related with emotion-oriented coping.
8.Palliative Forequarter Amputation; Indication, Technique And Outcome
Narhari P ; Singh A ; Azid A ; Osman Z
Malaysian Orthopaedic Journal 2018;12(Supplement A):95-
9.Cerebral Amyloid Angiopathy: An Important Differential Diagnosis of Stroke in the Elderly
Shahrul Azmin ; Syazarina Sharis Osman ; Shahizon Mukari ; Ramesh Sahathevan
Malaysian Journal of Medical Sciences 2015;22(1):74-78
Cerebral amyloid angiopathy (CAA) accounts for approximately 10–20% of spontaneous intracerebral haemorrhage (ICH). This figure is thought to be higher in the elderly population. With the increasing life expectancy of our population, we anticipate that the prevalence of CAA- related ICH will increase in tandem. Although CAA-related ICH and hypertension-related ICH are distinct entities based on histopathology and imaging, the clinical presentation of the two conditions is similar. The use of brain computed tomography (CT) scans remain the ICH imaging modality of choice in Malaysia due to its availability, cost, and sensitivity in detecting acute bleeds. On the other hand, the use of brain magnetic resonance imaging (MRI) with susceptibility-weighted imaging (SWI) sequencing enables the clinician to determine the presence of chronic blood products in the brain, especially clinically silent microbleeds associated with CAA. However, the use of brain MRI scans in our country is limited and leads to a blurring of lines when differentiating between hypertension-related ICH and CAA-related ICH. How this misrepresentation affects the management of these conditions is unclear. In this study, we present two cases of ICH to illustrate this point and to serve as a springboard to question current practice and promote discussion.
10.Posterior reversible encephalopathy associated with HELLP syndrome: A case report and review of the literature
Seda Ates ; Rahsan Kemerdere ; Osman Sevket ; Taner Molla ; Banu Dane
Neurology Asia 2015;20(1):91-94
We report a case of posterior reversible encephalopathy syndrome in association with hemolysis-elevated
liver enzymes-low platelet counts (HELLP) syndrome. A 29-year-old primigravida presented at 35 weeks
4 days pregnancy with headache and blurred vision and the laboratory data revealed hemolysis, elevated
liver enzymes, and low platelets. Cranial magnetic resonance imaging (MRI) showed hyperintense
signal changes in the right occipital, left cerebellar regions and the right thalamus. Follow up brain
MRI 10 days after the caesarean section showed resolution of the previous abnormalities. Posterior
reversible encephalopathy syndrome (PRES) is a neuroradiologic condition associated with headache,
seizures, altered sensorium, and visual disturbances. Although their association is rare, the diagnosis
of PRES should be considered in all HELLP patients presenting with headache and neuro-ophthalmic
signs. It is for the reason that the patients can recover well with complete reversal of clinical symptoms
within several days, when adequate treatment is immediately initiated.
HELLP Syndrome