1.Unusual presentation of severe dengue: Dengue maculopathy
Kee Huat Chuah ; Christina Wei Khee Ng ; Zabri Kamarudin ; Chi Lun Wong
The Medical Journal of Malaysia 2017;72(1):73-74
Dengue infection is epidemic but ocular complications of
dengue are less reported. We report a case of dengueinfected
patient with disturbing ocular symptoms. He was
admitted for severe dengue. Subsequently, he presented
with symptoms of bilateral central scotoma with
metamorphosia. Fundus examination revealed cotton wool
spots and flame-shaped haemorrhages at the macula, with
dull foveal light reflex. He was diagnosed with bilateral
dengue maculopathy. The patient was managed
conservatively with surveillance. One week later, his eye
symptoms improved and were resolved six months later.
Early recognition and close monitoring remains the key to
successful management and interventions are rarely
needed.
Severe Dengue
;
Eye Diseases
3.Gastrointestinal Dysfunction in Parkinson’s Disease: Neuro-Gastroenterology Perspectives on a Multifaceted Problem
Ai Huey TAN ; Kee Huat CHUAH ; Yuan Ye BEH ; Jie Ping SCHEE ; Sanjiv MAHADEVA ; Shen-Yang LIM
Journal of Movement Disorders 2023;16(2):138-151
Patients with Parkinson’s disease (PD) face a multitude of gastrointestinal (GI) symptoms, including nausea, bloating, reduced bowel movements, and difficulties with defecation. These symptoms are common and may accumulate during the course of PD but are often under-recognized and challenging to manage. Objective testing can be burdensome to patients and does not correlate well with symptoms. Effective treatment options are limited. Evidence is often based on studies in the general population, and specific evidence in PD is scarce. Upper GI dysfunction may also interfere with the pharmacological treatment of PD motor symptoms, which poses significant management challenges. Several new less invasive assessment tools and novel treatment options have emerged in recent years. The current review provides an overview and a practical approach to recognizing and diagnosing common upper and lower GI problems in PD, e.g., dyspepsia, gastroparesis, small bowel dysfunction, chronic constipation, and defecatory dysfunction. Management aspects are discussed based on the latest evidence from the PD and general populations, with insights for future research pertaining to GI dysfunction in PD.