1.Pedunculated Hepatocellular Carcinoma: Distinguishing Features from Conventional Hepatocellular Carcinoma
The International Medical Journal Malaysia 2016;15(1):110-113
Malignant pedunculated (exophytic) hepatocellular carcinoma (P-HCC) is a rare entity of hepatocellular
carcinoma. Due to its unique characteristics, it gives a different spectrum of clinical findings, radiological
presentation and different management approach with reported better outcome to the patients. We
present a case report of a lady diagnosed with malignant pedunculated hepatocellular carcinoma.
2.Giant Cell Reparative Granuloma Mimicking Aneurysmal Bone Cyst in Proximal Phalanx of Toe
Malaysian Orthopaedic Journal 2016;10(1):55-56
Giant Cell Reparative Granuloma (GCRG) of phalanx is
uncommon. It is a benign osteolytic lesion but can be locally
aggressive. GCRG has certain radiology and histological
features that are similar to other giant cell lesions of the
bone. We present a case report of a young patient with giant
cell reparative granuloma of proximal phalanx of left third
toe. The bone lesion was successfully treated surgically.
Granuloma, Giant Cell
3. Phytocompounds of Anonna muricata leaves extract and cytotoxic effects on breast cancer cells
Husna Syakirah Ab RAHMAN ; Michael Pak-Kai WONG ; Mohd Ridzuan Abdul SAMAD ; Mohd Nizam Md HASHIM ; Wan Suriyani WAN-IBRAHIM ; Norzila ISMAIL ; Siti Farhanah MOHD-SALLEH ; Tuan Nadrah ISMAIL
Asian Pacific Journal of Tropical Medicine 2018;11(12):659-665
Objective: To identify the phytochemical compounds from Annona muricata (A. muricata) and to determine their in vitro anti-proliferative activities against breast cancer cells, MCF7 and MDA-MB-231. Methods: A. muricata leaves were successively extracted by soxhlet method using n-hexane, ethyl acetate and methanol, and decocted with water. Each extract was analysed by gas chromatography mass spectrometry (GCMS) and characterized with Wiley and NIST library searches. Anti-proliferative activity of each extract was evaluated on MCF7 and MDA-MB-231 breast cancer cells using MTT assay. Results: The GCMS analysis of different solvent extracts of A. muricata leaves showed presence of different chemical groups of compounds such as steroids, terpenoids, phenolic compounds, sugars, sugars alcohol and others including vitamin E. Ethyl acetate leaves extract exhibited the lowest IC
4.Paediatric asthma clinical pathway: Impact on cost and quality of care
Shakirah Md.Sharif ; Jamalludin Ab Rahman ; Hasniah Abdul Latif ; Rus Anida Awang ; Mariana Daud ; Ahmad Fadzil Abdullah ; Dayang Zuraini Sahadan ; Su Siew Choo ; Ramli Zainal ; Samsinah Hussain ; Norzila Mohamed Zainudin
The Medical Journal of Malaysia 2019;74(2):138-144
INTRODUCTION: Uncontrolled asthma may cause an
increase in healthcare utilisation, hospital admission and
productivity loss. With the increasing burden of asthma in
Malaysia, strategies aimed at reducing cost of care should
be explored. OBJECTIVE: This study aims to determine if a
clinical pathway (CPW) for inpatient paediatric asthma
would reduce average length of stay (ALOS), improve
asthma management and decrease cost.
METHODS: A quasi-experimental, pre-post study was used
to evaluate the CPW effectiveness. Paediatric inpatients
aged 5-18 years old, admitted for acute asthma exacerbation
from September 2015 to April 2016 were prospectively
recruited. Data from patients admitted from January-July
2015 were used as control. CPW training was carried out in
August 2015 using standardised modules. Direct admission
cost from the provider's prospective was calculated.
Outcomes compared were differences in ALOS, discharge
medication, readmission within 28 days of discharge and
cost.
RESULTS: ALOS is 26 hours lower in the CPW group for
severe exacerbations and underlying uncontrolled asthma
(19.2 hours) which is clinically significant as patients have
shorter hospital stay. More newly-diagnosed intermittent
asthmatics were discharged with relievers in the CPW group
(p-value 0.006). None of the patients in the CPW group had
readmissions (p-value 0.16). Mean treatment cost for
patients in the intervention group is higher at RM843.39 (SD
±48.99, versus RM779.21 SD±44.33).
CONCLUSION: This study found that management using a
CPW may benefit asthmatic patients with uncontrolled
asthma admitted with severe exacerbation. Further studies
will be needed to explore CPW's impact on asthma
management starting from the emergency department.