Leiomyosarcoma is a rare cancer and the presence of this type of cancer in the breast is even rarer. Due to its rarity, the management options for leiomyosarcoma of the breast are not well documented. Literature review was done to establish the best treatment options for this type of breast cancer.
Breast Neoplasms ; Leiomyosarcoma

China ; ethnology ; Female ; Gallbladder ; physiopathology ; surgery ; Humans ; Middle Aged ; Singapore ; Torsion Abnormality ; physiopathology

Aged ; Aged, 80 and over ; Cholangiopancreatography, Endoscopic Retrograde ; Cholestasis, Extrahepatic ; diagnosis ; etiology ; Common Bile Duct Diseases ; diagnosis ; etiology ; Diverticulum ; complications ; Female ; Humans

Amblyopia is one of the most common causes of visual defi cit in children. Presently, in the Ministry of Health Malaysia hospitals, there is no documented data on the characteristic and profi le of amblyopia cases. This study was conducted to describe the profi le of new amblyopia cases seen by optometrists at the Ministry of Health (MOH) Hospitals. This study was a retrospective and multicenter study including all MOH hospitals with optometry clinics. Clinical record data of amblyopic patients aged 3 to 17 years old who were newly diagnosed between 1st August 2010 to 31st January 2011 and who fulfi lled the inclusion criteria were obtained. Data collected included demography, systemic history, ocular history and optometric fi ndings and diagnosis. Thirty eight MOH hospitals participated and a total of 301 patients were diagnosed with functional amblyopia within the study period. Mean age for these amblyopic patients was 7.70 + 0.16 years old. Boys were the predominant gender (57.1%) and Malay preceded the other races with a 65.4% occurrence. Mild amblyopia was found in 51.5% of the patients, 31.6% were with moderate amblyopia and only 16.9% of patients were severe amblyopia. The underlying amblyogenic causes assessed were ametropia (61.5%), anisometropia (25.2%), strabismus (9.3%) and stimulus deprivation (4.0%). Refractive error was discovered as the most common cause of amblyopia in this study. It is crucial for optometrists to detect this type of visual impairment and undertake an early optometric intervention

INTRODUCTIONLaparoscopic cholecystectomy for acute cholecystitis is associated with higher rate of conversion to laparotomy. The value of several factors that might influence the rate of conversion is analysed.

MATERIALS AND METHODSIn a retrospective analysis of a prospective database, the medical records of patients who underwent laparoscopic cholecystectomy from May 1998 to June 2004 were reviewed. Patients who had acute cholecystitis and had undergone interval laparoscopic cholecystectomy were included in this study.

RESULTSOut of 1000 laparoscopic cholecystectomies, 201 were operated on for acute cholecystitis. One hundred and forty-five patients (72.3%) underwent successful laparoscopic cholecystectomy and 56 patients (27.7%) needed conversion to open cholecystectomy. Patient's age (P = 0.031), total white cell count (P = 0.014), total bilirubin (P = 0.002), alkaline phosphatase (P = 0.003) and presence of common bile duct stone (P = 0.001) were found to be independently associated with conversion.

CONCLUSIONLaparoscopic cholecystectomy can be performed safely for acute cholecystitis. Predictors of conversion will be helpful when planning the laparoscopic approach and for counselling patients preoperatively.

Adult ; Cholecystectomy, Laparoscopic ; adverse effects ; utilization ; Cholecystitis, Acute ; epidemiology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Retrospective Studies ; Risk Factors ; Singapore

Objective: To determine the anti-proliferative activity of Abrus precatorius (A. precatorius) leaf extracts and their effect on cell death. Methods: A. precatorius leaves were extracted successively with hexane, ethyl acetate and methanol by Soxhlet extraction. Aqueous extract was prepared by decoction at 50 ℃. Extracts of A. precatorius leaves were used to treat selected cancer and normal cell lines for 72 h. Furthermore, 3-(4,5-dimethyl thiazol-2-yl) 2,5-diphenyl tetrazolium bromide assay was performed to determine cell viability. Analysis of cell cycle arrest, apoptosis assay and apoptosis protein expressions were determined by flow cytometry. Results: Methanolic extract of A. precatorius leaves showed the lowest IC50 on MDA-MB-231 cells at (26.40±5.40) μg/mL. Flow cytometry analysis revealed that cell arrest occurred at G0/G1 phase and the apoptosis assay showed the occurrence of early apoptosis at 48 h in MDA-MB-231 cells treated with methanolic extract of A. precatorius leaves. Methanolic extract of A. precatorius leaves induced apoptosis by upregulation of Bax, p53 and caspase-3 and downregulation of Bcl-2. Conclusions: Methanolic extract of A. precatorius leaves promotes MDA-MB-231 cell death by inducing cell cycle arrest and apoptosis possibly via the mitochondrial-related pathway.

INTRODUCTIONEndoscopic transenteric stenting is the standard treatment for pseudocysts, but it may be inadequate for treating infected collections with solid debris. Surgical necrosectomy results in significant morbidity. Direct endoscopic necrosectomy (DEN), a minimally invasive treatment, may be a viable option. This study examined the efficacy and safety of DEN for the treatment of infected walled-off pancreatic necrosis and infected pseudocysts with solid debris.

METHODSThis study was a retrospective analysis of data collected from a prospective database of patients who underwent DEN in the presence of infected walled-off pancreatic necrosis or infected pseudocysts with solid debris from April 2007 to October 2011. DEN was performed as a staged procedure. Endoscopic ultrasonography-guided transgastric stenting was performed during the first session for initial drainage and to establish endoscopic access to the infected collection. In the second session, the drainage tract was dilated endoscopically to allow transgastric passage of an endoscope for endoscopic necrosectomy. Outcome data included technical success, clinical success and complication rates.

RESULTSEight patients with infected walled-off pancreatic necrosis or infected pseudocysts with solid debris (mean size 12.5 cm; range 7.8-17.2 cm) underwent DEN. Underlying aetiologies included severe acute pancreatitis (n = 6) and post-pancreatic surgery (n = 2). DEN was technically successful in all patients. Clinical resolution was achieved in seven patients. One patient with recurrent collection opted for surgery instead of repeat endotherapy. No procedural complications were encountered.

CONCLUSIONDEN is a safe and effective minimally invasive treatment for infected walled-off pancreatic necrosis and infected pseudocysts.

Adult ; Aged ; Cysts ; diagnosis ; diagnostic imaging ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Necrosis ; Pancreas ; pathology ; Pancreatic Diseases ; diagnosis ; diagnostic imaging ; surgery ; Pancreatitis, Acute Necrotizing ; diagnostic imaging ; surgery ; therapy ; Singapore ; Stents ; Treatment Outcome ; Ultrasonography

Objective: To determine the anti-proliferative activity of Abrus precatorius (A. precatorius) leaf extracts and their effect on cell death. Methods: A. precatorius leaves were extracted successively with hexane, ethyl acetate and methanol by Soxhlet extraction. Aqueous extract was prepared by decoction at 50 C. Extracts of A. precatorius leaves were used to treat selected cancer and normal cell lines for 72 h. Furthermore, 3-(4,5-dimethyl thiazol-2-yl) 2,5-diphenyl tetrazolium bromide assay was performed to determine cell viability. Analysis of cell cycle arrest, apoptosis assay and apoptosis protein expressions were determined by flow cytometry. Results: Methanolic extract of A. precatorius leaves showed the lowest IC

Introduction: Musical-based education has been linked with improved students’ academic performance and mental wellbeing. This study aimed to evaluate a musical-based anatomy learning module using the combination of music, choreographed movements and 3D anatomy illustrations on muscles of the hand. Methods: A 5-minute duration video on muscles of the hand was developed through series of discussions with expert panels to incorporate the three stated components, emphasizing on the use of catchy music and simple terms to assist memorization skills. A single arm quasi-experimental pilot study was conducted with pre- and post-intervention measurement of knowledge, perception, stress and happy index related to learning anatomy. A total of 157 medical students were recruited and exposed to a total of 20 minutes video duration over three days. The effectiveness of the intervention was investigated using paired t-test and was interpreted based on the pre- and post-measured exposure mean differences. Results: The newly developed musical-based anatomy learning module had effectively improved knowledge and happy index related to learning anatomy, with significant mean differences were observed on the total mean scores for knowledge (MD= 2.707, p< 0.001) and happy index (MD=3.256, p< 0.001), as well as significant reduction of the mean scores for the negative items for perceptions and stress. Conclusion: The improved knowledge and happy index related to learning anatomy reflecting the positive impact of music used in combination choreographed movements and 3D illustrations to strengthen memorizing skills of medical students as well as instilling positive mood.

Introduction: Aedes albopictus is known for its aggressiveness towards human and recently expanded to more countries outside the native regions. Thus, the demographic parameters of Aedes albopictus are important to determine the characteristics of this species mosquitoes in terms of the reproduction rates and dispersal distance. Materials and Methods: This study, was performed using a Shah Alam strain of Aedes albopictus originally collected in twenty district areas of the central zone of Shah Alam. This research applies field work-study with a cross-sectional design to investigate the demographic parameters of Aedes albopictus. The demographic evaluation of Aedes albopictus was conducted under the control environment in insectarium. Results: Investigation on the demographic parameters of Aedes albopictus clearly showed that there is a significance different observed in the total number of mosquito eggs produced in both high and low incidence rate IR areas (p=0.03). In contrast, other parameters showed insignificant value between high and low IR areas. Conclusion: The key to control the mosquito vectors population is by tracking the vector’s life cycle including its survival. Therefore, the outcome of this study may provide as a baseline to estimate the dengue outbreak in the current episystem.