Complex Indirect Carotid-Cavernous Fistula With Contralateral Ophthalmic Manifestations.

A carotid-cavernous fistula (CCF) involves an abnormal communication between the carotid artery and the cavernous sinus. For indirect CCF, it usually occurs in post-menopausal women. Contralateral symptoms for indirect CCF are rare.

Navigating Diagnostic Complexities and Treatment Strategies of Moyamoya Syndrome: A Case Report.

Moyamoya syndrome (MMS) is characterized by progressive narrowing of intracranial arteries and the development of collateral vessel networks, often presenting with recurrent ischemic or hemorrhagic strokes. MMS poses significant challenges in diagnosis due to its overlapping symptoms with other cerebrovascular conditions. Treatment aims to improve cerebral blood flow, reduce symptom frequency, and prevent future strokes.

Effectiveness of the Stroke e-Learning Module on Malaysian Doctors' Knowledge of Acute Ischaemic Stroke Management.

Background: The Stroke e-Learning Module (SEM) is a nationwide initiative to improve stroke care in Malaysia. This study aimed to assess the module's effectiveness in improving knowledge on acute ischaemic stroke (AIS) management among Malaysian doctors.

Methods: This was a pre-post study design.

An integrative review on physical restraint in adult critical care unit.

Background: Physical restraints (PRs) are frequently used in adult critical care units to protect staff and prevent self-harm, despite the fact that they represent significant safety risks. Restraint complications may have an impact on the patient's long- and short-term outcomes. This integrative review aimed to meticulously evaluate existing evidence pertaining to physical restraint practices in adult critical care settings.

Surgical outcome of angular deformity correction of lower limbs in rickets: a cross-sectional study.

Purpose: This study aims to compare the functional and radiological outcomes following both guided growth surgery (GGS) and acute corrective osteotomy (ACO) correction of angular deformities in children with rickets.

Methods: A total of 8 and 7 children who had gradual GGS and ACO correction, respectively, for angular deformities due to rickets from 2002 to 2022 were recalled for follow-up. Demographic data, types of rickets, data on pharmacological treatment, biochemical parameters, recurrence of angular deformity and postoperative complications were obtained from the medical records.

Visible and angular interrogation of Kretschmann-based SPR using hybrid Au-ZnO optical sensor for hyperuricemia detection.

Uric acid is a waste product of the human body where high levels of it or hyperuricemia can lead to gout, kidney disease and other health issues. In this paper, Finite Difference Time Doman (FDTD) simulation method was used to develop a plasmonic optical sensor to detect uric acid with molarity ranging from 0 to 3.0 mM.

The Spectrum of Vessel Wall Imaging (VWI) Findings in COVID-19-Associated Neurological Syndromes: A Review.

Since the start of the pandemic, there have been extensive studies from all over the world reporting on coronavirus disease 2019 (COVID-19)-associated neurological syndromes. Although initially thought of as primarily a respiratory pathogen, it became increasingly clear that the virus does have other systemic manifestations, including on the neurological system. Since then, the discovery of the many neuroimaging features of COVID-19-associated neurological syndromes have puzzled researchers and physicians in terms of interpretation, and how best to manage these findings to benefit patients.

The Osseous Pathology of Purpura Fulminans in a Two-Year-Old Child: A Case Report.

Purpura fulminans (PF) is a severe clinical manifestation of infection that is associated with high mortality rates in children. Survivors are frequently left with debilitating musculoskeletal sequelae. There is a paucity of reports on the musculoskeletal pathology of purpura fulminans.

Establishing a hyperacute stroke service during the COVID-19 pandemic: our institution's one year experience.

Background And Aims: The corononavirus 2019 (COVID-19) pandemic resulted in modifications in the workflow and redistribution of human resources, causing challenges in setting up of an acute stroke service. We would like to share our preliminary outcome amid this pandemic, to determine if the implementation of COVID-19 standard operating procedures (SOPs) affected the delivery of our hyperacute stroke service.

Methods: We retrospectively analyzed one-year data from our stroke registry that began with the establishment of our hyperacute stroke service at Universiti Putra Malaysia Teaching Hospital from April 2020 until May 2021.

Case report: Incomplete penetrance of autosomal dominant myotonia congenita caused by a rare variant c.1667T>A (p.I556N) in a Malaysian family.

Myotonia congenita (MC) is a rare neuromuscular disease caused by mutations within the gene encoding skeletal muscle chloride channels. MC is characterized by delayed muscle relaxation during contraction, resulting in muscle stiffness. There is a lack of MC case reports and data on the prevalence among Malaysians.

Assessing knowledge, acts of discrimination, stigmatizing attitudes and its associated factors towards people living with HIV (PLHIV) among Family Medicine trainees in Malaysia.

Introduction: Human immunodeficiency virus (HlV)-related stigmatisation and discrimination adversely affect health outcomes in terms of timely diagnosis, treatment and care. Despite global efforts, they remain common among healthcare workers worldwide. In Malaysia, family medicine specialists are entrusted with the care of HIV patients at the primary care level.

The Utility of Vessel Wall Imaging in the Postulation of Acute Ischemic Stroke With Spontaneous Recanalization Pathophysiology.

Recent advances in technology, particularly in the field of magnetic resonance imaging, have brought forth new sequences, including vessel wall imaging (VWI). Traditionally, the workup for intracranial vascular pathology has always turned to luminal imaging using computed tomography angiography, magnetic resonance angiography, or digital subtraction angiography. Since its introduction, VWI has enabled researchers and practicing clinicians to better understand disease processes and manage patients to the best standard of care possible.

The prominent hypointense vessel sign on susceptibility-weighted imaging (SWI) as a potential imaging biomarker for poor clinical outcome in acute ischemic stroke (AIS).

Susceptibility-weighted imaging (SWI) is a relatively new magnetic resonance imaging (MRI) technique used in the workup and diagnosis of brain pathologies. In the context of acute ischemic stroke (AIS), it is increasingly becoming useful in the diagnosis, treatment, and further management of these patients. An elderly man with metabolic syndrome presented to us with an acute onset of right sided body weakness and aphasia.

Diagnostic Accuracy of Centor Score for Diagnosis of Group A Streptococcal Pharyngitis among Adults in Primary Care Clinics in Malaysia.

Background: Pharyngitis is a common presentation seen in general practice, but it is difficult to differentiate whether its etiology is viral or bacterial. The Centor score gives an approximation of the etiology of the pharyngitis, which informs physicians of the need to prescribe antibiotics. This study aimed to assess the validity of the Centor score in diagnosing Group A streptococcal (GAS) pharyngitis amongst adults in Malaysia.

Toe Macrodactyly, Macrodystrophia Lipomatosa, Fibrolipomatous Hamartoma and Lipomatosis of Nerve. Are they similar?: A Case Report.

Macrodystrophia Lipomatosa (MDL) of the toe is a rare, congenital, disproportionate overgrowth involving one or more digits in the lower limb. Despite being a benign condition, when left untreated, it may cause physical impairment and interfere with daily activities. This form of localised gigantism is the result of excessive proliferation of fibroadipose tissue within the nerve along with associated macrodactyly.

Straight versus Coiled Catheters in Peritoneal Dialysis in a Tertiary Care Center in Malaysia.

Introduction: Despite improvements in insertion techniques and catheter designs, catheter malfunction and infection pose a great source of morbidity and limitation to adequate dialysis. The two most used peritoneal dialysis (PD) catheters are the coiled and straight PD catheters. Existing studies show conflicting results.

Antibiotic Prescribing Patterns for Patients with Pharyngitis in Malaysian Public Primary Care Clinics.

Background: Over-prescription of antibiotics for upper respiratory tract infection (URTI) is a continuing problem in Malaysia, leading to increased antimicrobial resistance and unnecessary cost incurred for treatment. In a patient presenting with a sore throat, it is recommended to only prescribe antibiotics to group A streptococcus (GAS) pharyngitis confirmed by a throat culture, rapid antigen test or in patients with a Centor score of 4.

Methods: This cross-sectional study assessed the proportion of antibiotics prescribed and antimicrobial susceptibility patterns of GAS pharyngitis in the Malaysian primary care setting.

Catheter-related Infections and Microbiological Characteristics in Coiled Versus Straight Peritoneal Dialysis Catheters in Malaysia.

Background: Catheter-related infections remain a threat in peritoneal dialysis (PD) patients. Attempts to improve catheter insertion techniques and catheter type with best infectious outcomes yield heterogenous results. We seek to determine catheter-related infections in two different types of catheters and its microbiological spectrum.

Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report.

Background: Transverse myelitis (TM) is a relatively uncommon condition, and vaccine-associated myelitis is even rarer. Concern regarding neurological complications following vaccination escalated following the report of TM during the safety and efficacy trials of the COVID-19 vaccine.

Case Presentation: We report the first case of Longitudinal Extensive Transverse Myelitis (LETM) in Malaysia following administration of the chimpanzee adenovirus-vectored (ChAdOx1 nCoV-19) vaccine.

Anxiety Reaction in Children During Cast Removal using Oscillating Saw versus Cast Shear - A Randomised, Prospective Trial.

Introduction: To compare the anxiety levels demonstrated by children during cast removal procedure between oscillating saw vs cast shear methods.

Material And Methods: A randomised prospective study of 102 children (mean age 8.3 ± 3.

Angular Deformities of the Knee in Children Treated with Guided Growth.

Introduction: The guided growth technique is an alternative to corrective osteotomy for treating angular deformities of the extremities. It has the advantage of being minimally invasive and is effective in a growing child. This study reports on the outcome of guided growth technique using a plate in correcting knee angular deformities.

The role of social media in primary care.

Online activities have become the norm. From searching for new information to conducting business meetings, social media's role in daily life continues to grow in prominence. It is estimated that the majority of the population uses social media, and users include doctors and other healthcare professionals.