The Medical journal of Malaysia
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Primary sclerosing cholangitis (PSC) is the most common liver disease and known hepatobiliary complication of ulcerative colitis (UC). Concomitant PSC in UC is associated with increased risk of rapid progression of primary sclerosing cholangitis, and malignancy including colon carcinoma as well as hepatobiliary carcinoma. We report a case of a 26-year-old woman who was diagnosed as ulcerative colitis during her second pregnancy. ⋯ A clinical suspicion of primary sclerosing cholangitis was then made. Magnetic resonance cholangiopancreticography (MRCP) revealed beaded appearance of the right and left intrahepatic ducts with focal narrowing seen at the ducts, suggestive of primary sclerosing cholangitis. She was subsequently started on oral Ursodeoxycholic acid (UDCA) with improvement in her liver function test within 3 weeks of initiation of treatment.
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COVID-19 has infected more than 10 million people worldwide and it has become one of the biggest challenges in the modern medical history. Wearing of face masks, social distancing, effective hand hygiene and the use of appropriate personal protective equipment are important in flattening the curve of the pandemic. The role of the surgeons in this battle against COVID-19 include curbing the spread of the disease, to protect and preserve the surgical workforce and to ensure the continuance of essential surgical services. We report our experience in dealing with the COVID-19 outbreak in a tertiary surgical centre in the Penang General Hospital in Northern Malaysia.