The Malaysian journal of medical sciences : MJMS
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Case Reports
A gluteal mass of langerhans cell histiocytosis mimicking malignancy in a two-year-old boy: a case report.
Langerhans cell histiocytosis is a disease primarily affects the bone. More than 50 percent of the disease occurs between the age of 1 and 15. ⋯ Radiographic imaging showed an osteolytic lesion suspicious of malignancy. However, the histological diagnosis was Langerhans cell histiocytosis.
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A repeat Computer Tomographic (CT) brain after 24-48 hours from the 1(st) scanning is usually practiced in most hospitals in South East Asia where intracranial pressure monitoring (ICP) is routinely not done. This interval for repeat CT would be shortened if there was a deterioration in Glasgow Coma Scale (GCS). Most of the time the prognosis of any intervention may be too late especially in hospitals with high patient-to-doctor ratio causing high mortality and morbidity. ⋯ Different referral hospitals of different trauma level, GCS status, motor component of the GCS, haemoglobin level, platelet count and time interval between trauma and the first CT brain were the significant predictors for DTICH. Whereas the key determinants of PTBI were age, race, types of admission, GCS status, pupillary changes, number of intracranial bleed, haemoglobin level, prothrombin time and of course time interval between trauma and first CT brain. Any patients who had traumatic head injury in hospitals with no protocol of repeat CT scan or intracranial pressure monitoring especially in developing countries are advised to have to repeat CT brain at the appropriate quickest time .
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This short review explores the current status of cardiopulmonary resuscitation in Malaysia and highlights some of the factors that have a negative impact on its rate of success. Absence of a unifying body such as a national resuscitation council results in non-uniformity in the practice and teaching of cardiopulmonary resuscitation. ⋯ In the in-hospital setting, often times, resuscitation is first attended by junior doctors or nurses lacking in the skill and experience needed. Resuscitation trolleys were often inadequately equipped.
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The purpose of this study was to evaluate the anaesthetic technique for Caesarean section which was appropriate for the clinical situation. This retrospective study was conducted on 240 patients undergoing Caesarean section with indications of foetal distress during a 3-year period (2002-2004). The data were reviewed from the patient's medical record of the Department of Anesthesiology, Dr Soetomo Hospital, Surabaya. ⋯ One-minute Apgar score of the ketamine group was significantly higher than that of the thiopental group (p<0.05), but no significant differences in 5-minute Apgar score was found between the ketamine and the thiopental groups (p>0.05). We conclude that subarachnoid block is the choice of anaesthesia for patients undergoing Caesarean section for foetal distress's diagnosed at PS 1 and 2 patients. General anaesthesia with ketamine Apgar score at one minute better than that of the thiopental.
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Rheumatic mitral stenosis is prevalent in this part of the world and it gives rise to wide array of manifestations. However, hoarseness of voice secondary to recurrent laryngeal nerve paralysis (Ortner's syndrome) is an uncommon manifestation. This case illustrates an uncommon presentation in a common disease. ⋯ The recurrent laryngeal nerve paralysis is mainly due to the compression by an enlarged pulmonary artery as initially thought. This complication is rarely seen nowadays due to greater awareness of the disease and earlier intervention. With the advent of percutaneous transvenous mitral valvotomy in the nineties, effective non-surgical intervention is plausible.