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Raffael bin I.,UKMMC | Rajesh S.,Traumatology and Rehabilitation
International Medical Journal Malaysia | Year: 2015

We describe a case of median nerve compression by gouty tophi. This is a rare condition and presented with loss of function with paraesthesia of both hands in addition to multiple tophis. Surgery was chosen for immediate relief, where a debulking of left flexor digitorum superficialis with decompression of carpal tunnel was done and resulted in improvement of symptoms but became complicated due to inadequate physiotherapy. Source

Tehrani S.J.T.,UKMMC | Faizah M.Z.,Medical Center | Kew T.Y.,Medical Center | Abdullah A.,UKMMC
International Journal of Pediatric Otorhinolaryngology Extra | Year: 2013

We present a case of Klippel-Feil syndrome in a 2-year-old Chinese girl who presented with global developmental delay and bilateral profound hearing loss. High resolution computed tomography (HRCT) of temporal bones showed bilateral common cavity malformations with hypoplastic internal auditory canals and anomalous labyrinthine segments of both facial canals. The labyrinthine segment of the right facial canal was duplicated. Her brain magnetic resonance imaging (MRI) showed aplasia of both vestibulocochlear nerves, while the cisternal and intracanalicular segments of both facial nerves were of normal caliber. These congenital anomalies, coupled with global developmental delay, precluded her candidacy for cochlear implantation. This case report is aimed at highlighting the association of inner ear malformations and in particular facial canal anomalies in Klippel-Feil syndrome. © 2013 Elsevier Ireland Ltd. Source

Busra M.F.B.M.,University of Kuala Lumpur | Chowdhury S.R.,UKMMC | Ismail F.B.,Ampang Puteri Specialist Hospital in Selangor | Saim A.B.,University of Kuala Lumpur | Idrus R.B.H.,UKMMC
Advances in Skin and Wound Care | Year: 2016

OBJECTIVE: When given in conjunction with surgery for treating cancer, radiation therapy may result in impaired wound healing, which, in turn, could cause skin ulcers. In this study, bilayer and monolayer autologous skin substitutes were used to treat an irradiated wound. MATERIALS AND METHODS: A single dose of 30 Gy of linear electron beam radiation was applied to the hind limb of nude mice before creating the skin lesion (area of 78.6 mm2). Monolayer tissue-engineered skin substitutes (MTESSs) were prepared by entrapping cultured keratinocytes in fibrin matrix, and bilayer tissue-engineered skin substitutes (BTESSs) were prepared by entrapping keratinocytes and fibroblasts in separate layers. Bilayer tissue-engineered skin substitute and MTESS were implanted to the wound area. Gross appearance and wound area were analyzed to evaluate wound healing efficiency. Skin regeneration and morphological appearance were observed via histological and electron microscopy. Protein expressions of transforming growth factor β1 (TGF-β1), platelet-derived growth factor BB (PDGF-BB), and vascular endothelial growth factor (VEGF) in skin regeneration were evaluated by immunohistochemistry (IHC). RESULTS: Macroscopic observation revealed that at day 13, treatments with BTESS completely healed the irradiated wound, whereas wound sizes of 1.1 ± 0.05 and 6.8 ± 0.14 mm2 were measured in the MTESS-treated and untreated control groups, respectively. Hematoxylin-eosin (H&E) analysis showed formation of compact and organized epidermal and dermal layers in the BTESS-treated group, as compared with MTESS-treated and untreated control groups. Ultrastructural analysis indicates maturation of skin in BTESS-treated wound evidenced by formation of intermediate filament bundles in the dermal layer and low intercellular space in the epidermal layer. Expressions of TGF-β1, PDGF-BB, and VEGF were also higher in BTESS-treated wounds, compared with MTESS-treated wounds. CONCLUSIONS: These results indicate that BTESS is the preferred treatment for irradiated wound ulcers. © 2016 Wolters Kluwer Health, Inc. Source

Nur Azurah A.G.,UKMMC | Wan Zainol Z.,UKMMC | Lim P.S.,UKMMC | Shafiee M.N.,UKMMC | And 4 more authors.
Scientific World Journal | Year: 2014

Aim. To examine the factors associated with placenta praevia in primigravidas and also compare the pregnancy outcomes between primigravidas and nonprimigravidas. Method. A retrospective cohort study was conducted in women who underwent caesarean section for major placenta praevia in a tertiary university hospital from January 2007 till December 2013. Medical records were reviewed. Result. Among 243 with major placenta praevia, 56 (23.0%) were primigravidas and 187 (77.0%) were nonprimigravidas. Factors associated with placenta praevia in the primigravidas were history of assisted conception (P = 0.02) and history of endometriosis (P = 0.01). For maternal outcomes, the nonprimigravidas required earlier delivery than primigravidas (35.76 ± 2.54 weeks versus 36.52 ± 1.95 weeks, P = 0.03) and had greater blood loss (P = 0.04). A vast majority of the primigravidas had either posterior type II or type III placenta praevia. As for neonatal outcomes, the Apgar score at 1 minute was significantly lower for the nonprimigravidas (7.89 ± 1.72 versus 8.39 ± 1.288.39 ± 1.28, P = 0.02). Conclusion. This study highlighted that endometriosis and assisted conception were highly associated with placenta praevia in primigravida. Understanding the pregnancy outcomes of women with placenta praevia can assist clinicians in identifying patients who are at higher risk of mortality and morbidity. Identifying potential risk factors in primigravida may assist in counseling and management of such patients. © 2014 Abdul Ghani Nur Azurah et al. Source

Siti Rohani A.H.,UKMMC | Tzar M.N.,UKMMC
Medical Journal of Malaysia | Year: 2013

A 60-year old Malay man presented with an intermittent lowgrade fever for 3 days and worsening of right ankle ulcers. He was known to have ischaemic heart disease, diabetes mellitus type 2, hypertension and end stage renal failure and was on regular haemodialysis. The organisms isolated from the peripheral and central blood specimens were identified as Ochrobactrum anthropi, a rarely encountered gramnegative bacillus with a unique antibiotic susceptibility profile. His condition improved after removal of the catheters and administration of antibiotic therapy. This case report highlights the importance of being wary of such rare, opportunistic pathogens and good communication between the microbiologists and the clinicians. Source

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