- Skin eruption induced by dieting - an underdiagnosed skin disease in Malaysia. [Case Reports]
- MFMalays Fam Physician 2019; 14(1):42-46
- Prurigo pigmentosa is an inflammatory dermatosis characterized by a pruritic, symmetrically distributed erythematous papular or papulo-vesicular eruption on the trunk arranged in a reticulated patter…
Prurigo pigmentosa is an inflammatory dermatosis characterized by a pruritic, symmetrically distributed erythematous papular or papulo-vesicular eruption on the trunk arranged in a reticulated pattern that resolves with hyperpigmentation. It is typically non-responsive to topical or systemic steroid therapy. The exact etiology is unknown, but it is more commonly described in the Far East countries. Dietary change is one of the predisposing factors. We report on nine young adult patients with prurigo pigmentosa, among whom five were on ketogenic diets prior to the onset of the eruptions. All cases resolved with oral doxycycline with no recurrence. We hope to improve the awareness of this uncommon skin condition among general practitioners and physicians so that disfiguring hyperpigmentation due to delayed diagnosis and treatment can be avoided.
- Pseudohypoparathyroidism: A case of hypocalcemia and hypothyroidism diagnosed during the postpartum period. [Case Reports]
- MFMalays Fam Physician 2019; 14(1):31-34
- We describe a 29-year-old Para 1 post-Emergency Lower Segment Caesarean Section (EMLSCS) for fetal distress and Preterm Rupture of the Membrane (PROM) referred by the Obstetric team for persistent br…
We describe a 29-year-old Para 1 post-Emergency Lower Segment Caesarean Section (EMLSCS) for fetal distress and Preterm Rupture of the Membrane (PROM) referred by the Obstetric team for persistent bradycardia. She had the typical features of Albright's Hereditary Osteodystrophy (AHO). The laboratory investigation revealed hypocalcemia, hyperphosphatemia with a high Parathyroid hormone (PTH) level and low free Thyroxine 4 (fT4) with high Thyroid Stimulating Hormone (TSH). The patient was diagnosed with Pseudohypoparathyroidism (PHP) Type 1A associated with TSH resistance based on the somatic features of AHO present as well as biochemical and radiological abnormalities.
- [Clinical features of chronic pancreatitis in children: a single-center retrospective study]. [Journal Article]
- ZEZhonghua Er Ke Za Zhi 2019 Jul 02; 57(7):515-519
- CONCLUSIONS: Idiopathic CP and anatomic abnormalities were the two main etiologies. Normal level of serum amylase and lipase or negative finding of ultrasound cannot exclude CP, while MRCP and MRI should be considered to improve CP diagnostic rate. It is noteworthy that growth delay would happen in children with CP history.
- Diagnostic performance of the current risk-stratified approach with computed tomography for suspected choledocholithiasis and its options when negative finding. [Journal Article]
- HPHepatobiliary Pancreat Dis Int 2019 Jun 18
- CONCLUSIONS: CT-based ASGE guideline showed superior diagnostic performance than US for predicting choledocholithiasis. The diagnostic options, EUS or MRCP, with negative CT finding showed comparable performance. Therefore, the diagnostic modality should be selected based on availability, experience, cost, and contraindications.
- Super-resolution for upper abdominal MRI: Acquisition and post-processing protocol optimization using brain MRI control data and expert reader validation. [Journal Article]
- MRMagn Reson Med 2019 Jul 01
- CONCLUSIONS: Our results underline the potential of using SRR alongside traditional MRCP data for improved clinical diagnosis.
- Cholangiocarcinoma in a Resected Biliary Cyst: Importance of Follow-up. [Case Reports]
- CCureus 2019 Apr 24; 11(4):e4532
- Biliary cysts are rare cystic dilatations of the biliary tree. Biliary cysts are positively associated with several significant complications, amongst them, cholangiocarcinoma befalls the most dreadf…
Biliary cysts are rare cystic dilatations of the biliary tree. Biliary cysts are positively associated with several significant complications, amongst them, cholangiocarcinoma befalls the most dreadful one. The elevated incidence is 20-30% in the unresected cyst and 0.7% in resected cysts. Magnetic resonance imaging (MRI) scan, magnetic resonance cholangiopancreatography (MRCP) or a contrast-enhanced computed tomography (CECT) is applied for the initial diagnostic study but the ultimate diagnosis ordinarily requires the tissue biopsy. Currently, the sole curative option involves the complete surgical resection of the lesion, with standard chemotherapy and active radiation applied as an alternative for the unresectable tumors. Despite the curative surgery the percentage of eternal recurrence of the tumor indefinitely persists, and effective post-surgical surveillance is reasonably demanded. We report a case of 29-year-old female with local recurrence of cholangiocarcinoma in a previously resected biliary cyst type I. The curative resection of the choledochal cyst only minimizes the considerable risk of the possible development of future cholangiocarcinoma but it does not completely prevent it. The appropriate follow-up for potential patients who have been typically treated for a biliary cyst is unclear. The lethal course of cholangiocarcinoma is believed due to its slow asymptomatic growing phase. Therefore, to adequately screen for malignancy, periodic imaging along with annual liver tests represents a reasonable approach to prevent the possible development of this appalling complication.
- Acute pancreatitis with Cullen's sign presentation in a case of mixed type I and II choledochal cyst. [Journal Article]
- JPJ Pediatr Surg 2019 Jun 20
- A 3 year old girl presented initially with acute severe hemorrhagic pancreatitis diagnosed by clinical features including a positive Cullen's sign and raised serum amylase. A contrast enhanced comput…
A 3 year old girl presented initially with acute severe hemorrhagic pancreatitis diagnosed by clinical features including a positive Cullen's sign and raised serum amylase. A contrast enhanced computed tomography (CECT) scan corroborated the same and also reported a type I choledochal cyst. Magnetic resonance cholangiopancreatography (MRCP) 2 months later reported a type II choledochal cyst and a persistent pseudo pancreatic cyst. Intraoperative features and close perusal of the CECT and MRCP films showed the presence of mixed type I and II choledochal cyst. The case is reported for the presence of Cullen's sign, CECT and MRCP features of a mixed type I and II choledochal cyst and successful surgical outcome. It appears to be only the fifth case of mixed type I and II choledochal cyst in world literature in the pediatric age group, following the 4 previous cases in children reported from Japan.
- Effectiveness and Quality of Life with Montelukast in Asthma - A double-blind randomized control trial. [Journal Article]
- PJPak J Med Sci 2019; 35(3):731-736
- CONCLUSIONS: The role of montelukast in improving QOL of adult patients with mild to moderate persistent asthma is quite beneficial. It improves patient quality of life. It has the ease of once daily oral administration and also eradicates side effects associated with long-term adherence to steroids.
- The learning environment of four undergraduate health professional schools: Lessons learned. [Journal Article]
- PJPak J Med Sci 2019; 35(3):598-604
- CONCLUSIONS: The LE significantly differed by year and gender. The students from non-integrated curricula (nursing and AMS) perceived the LE less positively than their integrated curriculum counterparts (medicine and dentistry). A qualitative study is needed to investigate the variation in the perception of LE among these groups.
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- Correlation between Body Mass Index and Lipid Profile in patients with Type 2 Diabetes attending a tertiary care hospital in Peshawar. [Journal Article]
- PJPak J Med Sci 2019; 35(3):591-597
- CONCLUSIONS: A significant negative correlation between BMI and HDL-C was observed, while the correlation between BMI and LDL-C was observed to be insignificant. HDL-C was found significantly higher in patients with normal BMI. These results are important to indicate that there is modest impact of BMI on lipid profile. Therefore, assessment and management for altered blood lipids should not be based on a patient's body weight or BMI.