Author: Dennis Nyuk Fung Lim
A 66 year old Caucasian female presented with haemolytic uraemic syndrome (HUS) following a prodrome of diarrhoea. During the course of her illness, she developed acute heart failure secondary to myocardial ischaemia. Cardiovascular complications associated with HUS involving children have been reported in the literature. The mortality of adult patients with acute heart failure is significantly higher even with the initiation of therapeutic plasma exchange.
Keywords: Haemolytic uraemic syndrome, Cardiovascular complication.
Citation: IeJSME 2007: 1 (2): 80-82
Authors: Sivalingam Nalliah, Murali Ganesalingam, Ravindran Jegasothy.
The simultaneous presence of polycystic ovary syndrome with pelvic endometriosis presents compounded gynecological effects on women with subfertility and pelvic pain as the common symptoms. We describe one such case. The molecular basis for etiology is discussed and the need for individualized treatment is suggested.
Keywords: Polycystic ovary syndrome, pelvic endometriosis, simultaneous presence.
Citation: IeJSME 2008: 2 (2): 27-29
Authors: Sanadi Rizwan M
Gingival fibromatosis is frequently an isolated condition of little consequence apart from a cosmetic problem and occasional associations with uncommon syndromes. This case report of a 38 year old female patient describes the gingival enlargement associated with chronic periodontitis. The enlargement extended beyond the middle thirds of the clinical crowns of the teeth. It was associated with generalized mobility, pocket formation and bone loss. The patient also complained of bleeding gums and difficulty in speech and mastication. This is the first case report of gingival fibromatosis associated with chronic periodontitis.
Keywords: Bleeding gums, chronic periodontitis, gingival enlargement, gingival fibromatosis, mobility, pocket formation.
Citation: IeJSME 2009: 3 (2): 24-27
Author: Rizwan M Sanadi
Idiopathic gingival fibromatosis is a rare benign oral condition characterized by a slowly progressive, non-hemorrhagic, fibrous enlargement of maxillary and mandibular attached and non-attached gingivae. A 14 year old female patient suffered from unusual gingival enlargement, more on the left side along with generalized aggressive periodontitis. The enlarged gingiva covered more than two-thirds of the clinical crowns. Marked inflammatory hyperplasia of epithelium and connective tissue of the gingiva was observed histopathologically. Perioscan test was performed, the results of which were negative. The diagnosis of Idiopathic gingival fibromatosis with aggressive periodontitis was made. Conventional periodontal therapy was performed followed by excision of the enlargement using gingivectomy procedure.
Keywords: Aggressive periodontitis, Bleeding gums, Gingival enlargement, Gingival fibromatosis, Mobility, Pocket formation
Citation: IeJSME 2010: 4(2): 54-58
Author: Loh Huai Seng
A 3-year old preschool boy presented with a pruritic red streak at the dorsum of his right foot traveling upward from the affected site which was red and swollen. Insect sting was the more likely trigger which had caused the cellulitis and subsequently the acute lymphangitis.
Keywords: cellulitis, insect stings, lymphangitis, preschool child, streptococcal infections.
Citation: IeJSME 2012 6(2): 46-48
Authors: Meera Thalayasingam, Lynette Pei-Chi Shek.
Anaphylaxis in the operating room although infrequent can be potentially fatal.1 The diagnosis of perioperative anaphylaxis is complex due to a multitude of factors. Firstly, patients under anesthesia cannot verbalize their complaints, the anesthetic agents themselves can alter vital parameters (e.g. heart rate and blood pressure) and cutaneous signs in a completely draped patient may be missed.2 Secondly, the differential diagnosis of intraoperative anaphylaxis is wide. Conditions such as asthma exacerbation, arrhythmia, hemorrhage, angioedema, mastocytosis, acute myocardial infarction, drug overdose, pericardial tamponade, pulmonary edema, pulmonary embolus, sepsis, tension pneumothorax, vasovagal reaction, venous air embolism, laryngospasm, blood transfusion reaction and malignant hyperthermia need to be considered.3 Thirdly, the diagnostic workup is challenging due to the multiple medications administered and other exposures encountered such as latex and chlorhexidene. However, through a timely allergy consultation and a systematic approach, identification of the culprit agent and safe alternatives can be established to prevent future occurrences as illustrated in the case below.
Keywords: Allergy, anaphylaxis, cefazolin, cephalosporin, perioperative anaphylaxis.
Citation: IeJSME 2015 9(2): 37-39
Authors: Chin Voon Tong, Mohamad Rafie bin Md Kaslan.
In pregnancy, the diagnosis of primary hyperparathyroidism (PHP) may be delayed due to physiological changes that occur during this period. The maternal related complications of PHP during pregnancy has been reported to be as high as 67%, whilst fetal complications up to 80% of cases.1 The therapeutic gold standard and definitive treatment for PHP in pregnancy is minimally invasive parathyroidectomy in the second trimester. We report a case of a 22-year old primidgravida who underwent parathyroidectomy in the third trimester of her pregnancy for PHP with persistent hypercalcemia. She was also found to have Vitamin D deficiency which probably led to secondary hyperparathyroidism and made her hypercalcemia more apparent during pregnancy.
Keywords: Primary hyperparathyroidism, hypercalcemia, pregnancy, parathyroidectomy, vitamin D deficiency.
Citation: IeJSME 2015 9(3): 47-51
Authors: Norly Salleh, Aishah Ibrahim, Ros’aini Paijan.
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.
Keywords: breast cancer, leiomyosarcoma.
Citation: IeJSME 2015 9(3): 52-54
Authors: Rafiqahmed Vasiwala, Ismail Burud.
Malignant melanoma is a rare malignancy of the external auditory canal. The vast majority of them occur in the areas of the body that are exposed to the sun. Early histological examination may possibly favor better prognosis. We report a case of a 38-year-old female who presented with a small mass in right ear canal, earache and minimum discharge since 4 months. Initially scraping was done in the ENT clinic. Subsequently she had a wide excision done by the end aural approach at a different hospital. A year later the patient presented with a swelling involving the ear canal which extended to the helix and supratemporal region with the histology report as malignant melanoma. A literature review of the disease, radiological findings, immunohistochemical features and treatment options are discussed.
Keywords: ear canal, malignant melanoma, wart.
Citation: IeJSME 2016 10(1): 47-48
Authors: Ren Yi Kow, Dhiauddin Hai Ismail, Jamaluddin Shafie, Ruben Jaya Kumar, Nor Hafliza Md Salleh, Chooi Leng Low.
Marjolin’s ulcer is a malignant cutaneous ulcer that undergoes transformation from a previously traumatized or chronically inflammed skin.1 Causes leading to ulcerations can be burn injury, trauma, chronic osteomyelitis and varicose ulcers.2 It is named after a French surgeon, Jean Nicolas Marjolin, who first described the condition in patients who developed malignant ulcers from burn scars.3 We report a case of a chronic non-healing foot ulcer that has become a Marjolin’s ulcer after 12 years.
Keywords: Marjolin’s ulcer, chronic wound, squamous cell carcinoma, malignancies.
Citation: IeJSME 2016 10(3): 34-36